Evidence map›Paper›PMID 41557022›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026

The significance and utility of ventricular access devices in children with proximal CSF shunt malfunction.

Kerri Thorn, Brannan E O'Neill, Julie Wilson, Katherine Hofmann, Abdullah Feroze, Daniel A Donoho, Chima O Oluigbo, Hasan R Syed, Robert F Keating, John S Myseros

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Kerri ThornDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.
Brannan E O'NeillDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.. boneill1@childrensnational.org.
Julie WilsonDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.
Katherine HofmannDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.
Abdullah FerozeDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.
Daniel A DonohoDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.
Chima O OluigboDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.
Hasan R SyedDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.
Robert F KeatingDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.
John S MyserosDepartment of Neurosurgery, Children's National Health System, Washington, D.C., U.S.A.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe pediatric neurosurgical literature supports the placement of a ventricular access device (VAD) in the premature infant with posthemorrhagic ventricular dilatation as a temporizing measure prior to definitive diversionary shunting. However, there is an absence of data identifying the clinical utility and significance of VADs left in situ at the time of permanent shunt placement. The potential risks of leaving an initial VAD at the time of definitive contralateral cerebral spinal fluid (CSF) diversion and the benefits of a concomitant VAD in these patients with regard to potential life-saving or temporizing aspirations are not well documented.

methodsRetrospective cohort review of premature infants (< 37 weeks gestational age) treated for PHH at a tertiary pediatric neurosurgery center from January 2005 to December 2021. Patients were grouped by whether a previously placed VAD was retained during permanent shunt insertion. OUTCOMES MEASURED: number and outcome of VAD taps, shunt revisions, shunt infections. Statistical comparison between the two groups; p < 0.05 considered significant.

resultsSeventy-two premature patients (gestational age < 37 weeks) were identified. This cohort included 40 (55.55%) patients with both a VAD and shunt and 32 (44.44%) patients with a shunt only (12 with VAD removed at shunt insertion; 20 with no VAD insertion). Of the 40 patients with a shunt and VAD in situ, 17/40 (42.5%) had their VADs tapped at the time of shunt failure, resulting in 29 total VAD taps. There were 23 emergent VAD taps, of which 17/23 (73.91%) were successful. Leaving the VAD in situ did not result in increased rates of total shunt infections or revisions (p = 0.215; p = 0.129).

conclusionsBased on this analysis, VADs placed for initial management of post-hemorrhagic IVH may serve an important role in children with subsequent proximal shunt malfunctions, potentially lifesaving. A high percentage of shunted patients with VADs benefited without increased risk of shunt revisions or infections. The decision for a VAD to remain in situ at the time of permanent shunt placement in these patients should be strongly considered.

Indexed as

Cerebrospinal Fluid ShuntsHydrocephalusCohort StudiesEquipment FailureFemaleHumansInfantInfant, NewbornInfant, PrematureMaleRetrospective StudiesCSFVADVentricular access devices

Identifiers

PMID41557022

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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.