Evidence map›Paper›PMID 28357554›Full record

Trial reportChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2017

Outcome of treatment after failed endoscopic third ventriculostomy (ETV) in infants with aqueductal stenosis: results from the International Infant Hydrocephalus Study (IIHS).

Abhaya V Kulkarni, Spyros Sgouros, Shlomi Constantini, International Infant Hydrocephalus Study Investigators

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00652470 (International Infant Hydrocephalus Study), which is not on this map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.4field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00652470 phase2completednot on this map

International Infant Hydrocephalus Study: A Multicentre, Prospective Study

TypeinterventionalSponsorThe Hospital for Sick ChildrenRan2005 to 2018Enrolled182ConditionsHydrocephalusArmsEndoscopic Third Ventriculostomy, CSF Shunt Insertion
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 21 citations in OpenAlex.

  1. Trial
  2. Article
  3. Comparison of postoperative outcomes following endoscopic third ventriculostomy or shunt in a propensity score matched pediatric cohort.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025
    Article
  4. Review
  5. Toxoplasma gondii infections in pediatric neurosurgery.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024
    Review
  6. Repeat endoscopic third ventriculostomy success rate according to ventriculostoma closure patterns in children.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2021
    Article
  7. Article
  8. Prior endoscopic third ventriculostomy does not increase ventriculoperitoneal shunt failure rate.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2019
    Article
  9. TROPHY registry study design: a prospective, international multicenter study for the surgical treatment of posthemorrhagic hydrocephalus in neonates.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

Abhaya V KulkarniDivision of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, M5G 1X8, Canada. abhaya.kulkarni@sickkids.ca.
Spyros SgourosDepartment of Pediatric Neurosurgery, Mitera Children's Hospital, University of Athens Medical School, Athens, Greece.
Shlomi ConstantiniDepartment of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
International Infant Hydrocephalus Study Investigators
Tel Aviv University · ILNational and Kapodistrian University of Athens · GRUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAfter an endoscopic third ventriculostomy (ETV) fails, it is unclear how well subsequent treatment fares, especially in comparison to shunts inserted as primary treatment. In this study, we present a further analysis of the infants enrolled a prospective multicentre study who failed ETV and describe the outcome of their subsequent treatment, comparing this to those who received shunt as their primary treatment.

methodsThis was a post hoc analysis of data from the International Infant Hydrocephalus Study (IIHS)-a prospective, multicentre study of infants with hydrocephalus from aqueductal stenosis who received either an ETV or shunt. In the current analysis, we compared the results of the 38 infants who failed ETV and the 43 infants who received primary shunt. Patients were followed prospectively for time to treatment failure, defined as the need for repeat CSF diversion procedure (shunt or ETV) or death due to hydrocephalus.

resultsThere were a total of 81 patients: 43 primary shunts, 34 shunt post-ETV, and 4 repeat ETV. The median time between the primary ETV and the second intervention was 29 days (IQR 14-69), with no significant difference between repeat ETV and shunt post-ETV. Median length of available follow-up was 800 days (IQR 266-1651), during which time, failure was noted in 3 (75.0%) repeat ETV patients, 10 (29.4%) shunt post-ETV patients, and 9 (20.9%) primary shunt patients. In an adjusted Cox regression model, the risk of failure was higher for repeat ETV compared to primary shunt, but there was no significant difference between primary shunt and shunt post-ETV. No other variable showed statistical significance.

conclusionsIn our prospective study of infants with aqueductal stenosis, there was no significant difference in failure outcome of shunts inserted after a failed ETV and primary shunts. Therefore, our data do not support the notion that previous ETV confers either a protective or negative effect on subsequently-placed shunts. Larger studies, in a wider ranging population, are required to establish how widely these data apply.

trial registrationNCT00652470.

Indexed as

InternationalityFemaleFollow-Up StudiesHumansHydrocephalusInfantInfant, NewbornMaleNeuroendoscopyProspective StudiesThird VentricleTreatment FailureTreatment OutcomeVentriculostomyAqueductalEndoscopicShuntVentriculostomy

Identifiers

PMID28357554
OpenAlexW2597931643

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.