Abstract
Hydrocephalus is a common neurosurgical pathology associated with high patient morbidity and systemwide healthcare costs. A significant portion of these costs are related to the failure of ventricular shunting systems. Despite decades of research and technological development, the rate of shunt failure and revision has not significantly improved. The Reflow™ Ventricular System (Anuncia, Inc., Lowell, MA) is a recent technological development with the potential to prolong the shunt lifespan. This system introduces a noninvasive means of flushing a shunt proximally with a controlled, repeatable pulse of cerebral spinal fluid (CSF) and of creating a new ventricular opening for occluded shunts. In this multicenter case series, we present the early clinical experiences with this device and discuss its potential.
Highlights
Hydrocephalus is a common neurosurgical pathology, with a disproportionate degree of associated morbidity and resource utilization
Four (26%) had a neonatal hemorrhage, two (8%) had hydrocephalus secondary to tumor, two (8%) with a spontaneous hemorrhage, one (4%) with hemorrhage secondary to arteriovenous malformation (AVM), and one (4%) with aqueductal stenosis
After half a century of slow progress in the treatment for hydrocephalus, reduction in shunt failure remains the foremost goal of research endeavors
Summary
Hydrocephalus is a common neurosurgical pathology, with a disproportionate degree of associated morbidity and resource utilization. Received 03/23/2020 Review began 05/27/2020 Review ended 06/23/2020 Published 07/01/2020 These patients impose a heavy burden on healthcare systems. United States (US) hospitals discharge approximately 69,000 patients annually with a primary diagnosis of hydrocephalus, of which half undergo placement of a new shunt [4]. A review of the Nationwide Inpatient Sample database for 2000 in the US saw 27,870 patients undergo shunt-related procedures, 42.8% of which were replacements of existing shunts [5]. Over half of these admissions were classified as emergent or urgent, and the average cost was found to be 35,816 US dollars each [5]
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