Ventriculoperitoneal shunts equipped with on-off valves for intraventricular therapies in patients with communicating hydrocephalus due to leptomeningeal metastases

  • Ventriculoperitoneal shunts equipped with a reservoir and a valve to manually switch off the shunt function can be used for intraventricular injections of therapeutics in patients suffering from a communicating hydrocephalus caused by leptomeningeal metastases. These shunt devices avoid the risk of injecting therapeutics through the distal leg of the shunt system into the intraperitoneal space, which may cause toxicity. Furthermore, regular intraventricular injections of chemotherapeutics help to maintain sufficient concentrations in the ventricular space. Therefore, ventriculoperitoneal shunts equipped with an on-off valve are a useful tool to reliably inject chemotherapeutics into the ventricles. In order to systematically assess feasibility, safety, and efficacy of this procedure, we performed a retrospective analysis of all patients with leptomeningeal metastases who had received a shunt system at our institution. In total, six adult patients had a ventriculoperitoneal shunt equipped with an on-off valve implanted. Out of these six patients, two patients subsequently received intraventricular injections of chemotherapeutics. The configuration of the valve setting and the intraventricular injections were easily feasible in the setting of a neuro-oncology department. The complication of a shunt leakage occurred in one patient following the first intraventricular injection. No extra-central nervous system (CNS) toxicities were observed. In summary, ventriculoperitoneal shunts with on-off valves are useful tools for reliable intraventricular administration of therapeutics.

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Author:Michael Christian BurgerORCiDGND, Marlies Wagner, Kea Franz, Patrick Nikolaus HarterORCiDGND, Oliver Bähr, Joachim Peter SteinbachORCiDGND, Christian Alexander SenftORCiDGND
Pubmed Id:
Parent Title (English):Journal of Clinical Medicine
Place of publication:Basel
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/08/14
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/08/28
Tag:hydrocephalus; intraventricular chemotherapy; leptomeningeal metastases; ventriculoperitoneal shunt
Issue:8, Art. 216
Page Number:11
First Page:1
Last Page:11
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0