Use of lumboperitoneal shunts with the Strata NSC valve: a single-center experience

Abstract

The lumboperitoneal (LP) shunt with the adjustable PS Medical Strata NSC LP valve and small lumen peritoneal catheter was introduced in the authors' unit in 2007. The object of this study was to audit the unit's experience with this new shunt system. The authors performed a retrospective review of the clinical records of patients who underwent Strata NSC LP shunt insertion. Demographic and clinical data as well as information about complications and revisions were reported. Between August 2007 and November 2009, 20 patients underwent placement of an LP shunt with an adjustable Strata NSC valve and small lumen peritoneal catheter at the authors' institution. Their mean age was 40.3 years and the mean duration of follow-up was 12 months. Preoperatively, 18 patients had headache and 15 patients had visual signs and symptoms. Fourteen of the 18 patients with preoperative headache did not complain of headache postoperatively, and 4 had headache that was found not to be related to shunt function. Two of the patients with preoperative visual complaints had ongoing visual problems postoperatively. None of the patients had infection or subdural hematoma. The only overdrainage symptoms occurred in association with spontaneous readjustment of the valve and resolved when the valve was reset. Thirteen patients (65%) did not require shunt revision. Seven patients (35%) required 13 shunt exploration or revision procedures, mainly due to distal obstruction. Placement of an LP shunt failed to completely resolve the raised intracranial pressure problem in 2 patients. The use of the Strata NSC valve and small lumen peritoneal catheter is effective in treating pseudotumor cerebri and is beneficial in terms of markedly reducing overdrainage complications compared with other reported series of cases in which an LP shunt has been placed. However, the use of the Strata NSC valve and small lumen peritoneal catheter did not have a marked impact on other causes of shunt failure, particularly distal obstruction.