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Endoscopic third ventriculostomy (ETV) for treatment of adult hydrocephalus: long-term followup with 163 patients
Fluids and Barriers of the CNS volume 12, Article number: O8 (2015)
Introduction
Treatment of specific patterns of symptomatic hydrocephalus in the adult patient may be accomplished with endoscopic third ventriculostomy (ETV) as an alternative to insertion of a ventriculoperitoneal (VP) shunt or when VP shunt failure occurs. Treatment of hydrocephalus with a VP shunt, while effective, is associated with a significant shunt failure rate that results in VP shunt revision surgery. This review examines a single center experience with ETV to treat hydrocephalus in symptomatic adult patients.
Methods
Adult patients (>/=18 years) with a diagnosis of hydrocephalus who were treated with ETV in Calgary between January 1994 and July 2014 were reviewed using a clinic database and registry. All patients were treated by one neurosurgeon.
Results
163 adult patients with symptomatic hydrocephalus treated with ETV were identified (male=92; female=71). Mean age at the time of ETV was 46 years (range 18-83 years). 112 underwent ETV as a primary treatment and 51 patients underwent treatment after presenting with VP shunt failure (secondary ETV). 113/163 patients had a diagnosis of aqueductal stenosis, 22/163 had a diagnosis of tumor. Mean followup was 8.2 years (range 0.3-18.4 years). Symptoms in 149/163 (91.4%) of ETV patients were better or unchanged at last followup. 104/118 (88.1%) of primary ETV patients were shunt free at last followup. 39/45 (86.7%) of secondary ETV patients were shunt free at last followup.
Conclusions
Endoscopic (ETV) treatment of hydrocephalus is an effective longterm treatment in a select population adult patients with hydrocephalus. Outcome/results are similar for patients where ETV is used as either a primary or secondary treatment. 87-88% of patients remain shunt free with a mean 8.2 years of followup.
Learning objectives
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1)
To understand the role of ETV for primary treatment of hydrocephalus in the adult patient.
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2)
To understand the role of ETV for secondary treatment of hydrocephalus in the adult patient.
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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Isaacs, A., Urbaneja, G. & Hamilton, M. Endoscopic third ventriculostomy (ETV) for treatment of adult hydrocephalus: long-term followup with 163 patients. Fluids Barriers CNS 12 (Suppl 1), O8 (2015). https://doi.org/10.1186/2045-8118-12-S1-O8
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DOI: https://doi.org/10.1186/2045-8118-12-S1-O8