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Article Dans Une Revue Operative Neurosurgery Année : 2022

Mechanical Complications of Sophysa SM8 Shunt in Adult Hydrocephalus: A Monocentric Experience

Marta Arrighi
  • Fonction : Auteur
Quentin Berton
  • Fonction : Auteur
Aurélien Coste
  • Fonction : Auteur
Emmanuel de Schlichting
  • Fonction : Auteur
Jean Chazal
  • Fonction : Auteur
Laurent Sakka
  • Fonction : Auteur
Francis Abed Rabbo
  • Fonction : Auteur

Résumé

Background: Sophysa SM8 is widely used by neurosurgeons in France. Published studies report shunt malfunction rates in adults between 18% and 29%. However, these studies included multiple valve types and thus entailed a serious confounding factor. Objective: To ascertain the incidence the Sophysa SM8 cerebrospinal fluid (CSF) shunt malfunctions in adults. Methods: We present a retrospective series of adult patients who underwent CSF shunt placement between 2000 and 2013 with Sophysa SM8. Results: In total, 599 patients (329 males and 270 females) were included. The mean age at surgery was 64.15 years (19-90) (SD 16.17; median 68.0). The causes of hydrocephalus were normal pressure hydrocephalus (49%), traumatic hemorrhages (26.5%), tumors (15.7%), cerebral aqueduct stenoses (3%), and arachnoid cysts (2%). The mean follow-up was 3.9 years (0-16) (SD 4.10; median 3 years). The rate of complications was 22.04% (132 of 599). Most frequent causes of complications were disconnection (25%), migration (12.9%), overdrainage (9.1%), and proximal obstruction (6.8%). In 17 cases (12.9%), no failure was diagnosed during revision. Seven infections (5.3%) were reported. The mean delay for the first revision was 1.70 years (0-13.93) (SD 2.67, median 0.35). The risk of shunt failure was 36% at 10 years. Seventeen percent of revisions occurred during the first year after shunt placement. Conclusion: Disconnections are a very frequent complication of Sophysa SM8 valve. They are related to the 2-connector system of this valve. Based on these results, we recommend using 1-piece valves.
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Dates et versions

hal-04126506 , version 1 (13-06-2023)

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Guillaume Coll, Marta Arrighi, Quentin Berton, Aurélien Coste, Emmanuel de Schlichting, et al.. Mechanical Complications of Sophysa SM8 Shunt in Adult Hydrocephalus: A Monocentric Experience. Operative Neurosurgery, 2022, 23 (4), pp.318-325. ⟨10.1227/ons.0000000000000337⟩. ⟨hal-04126506⟩
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