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In vitro performance of combinations of anti-siphon devices with differential pressure valves in relation to the spatial position

  • Original Article - CSF Circulation
  • Published:
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Abstract

Background

Programmable differential pressure (DP) valves combined with an anti-siphon device (ASD) represent the current standard of care in preemtping overdrainage associated with ventriculoperitoneal shunting for hydrocephalus.

Objective

We aimed to provide comparative data of four combinations of two ASDs of different working principles in combination with two DP valves in an in vitro model in order to achieve a better understanding of the flow characteristics and potential clinical application.

Methods

We analyzed the flow performance of four possible combinations of two DP valves (CHPV [HM]; proGAV 2.0[PG]) in combination with either a gravity-regulated (Shuntassistant [SA]) or a flow-regulated (SiphonGuard [SG]) ASD in an in vitro setup. A DP between 4 and 60 cmH2O was generated, and the specific flow characteristics were measured. In addition, the two combinations with gravity-regulated ASDs were measured in defined spatial positions.

Results

Flow characteristics of the SA combinations corresponded to the DP in linear fashion and to the spatial position. Flow characteristics of the SG combinations were dependent upon the DP in a non-linear fashion and independent of the spatial position. Highest mean flow rate of the PG-SG- (HM-SG-) combination was 1.41 ± 0.24 ml/min (1.16 ± 0.06 ml/min). The mean flow rates sharply decreased with increasing inflow pressure and subsequently increased slowly up to 0.82 ± 0.26 ml/min (0.77 ± 0.08 ml/min).

Conclusion

All tested device combinations were able to control hydrostatic effect and prevent consecutive excessive flow, to varying degrees. However, significant differences in flow characteristics can be seen, which might be relevant for their clinical application.

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Authors and Affiliations

  1. Department of Neurosurgery, Universitätsmedizin Göttingen, Georg-August University Göttingen, 37099, Göttingen, Germany

    I. Fiss, M. Vanderheyden, C. von der Brelie, C. Bettag, F. Freimann & V. Rohde

  2. Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany

    N. Hore & S. Brandner

  3. Department of Paediatric Neurosurgery, Charité University Hospital, Berlin, Germany

    U.-W. Thomale

Authors
  1. I. Fiss
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  2. M. Vanderheyden
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  3. C. von der Brelie
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  4. C. Bettag
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  5. N. Hore
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  6. F. Freimann
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  7. U.-W. Thomale
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  8. V. Rohde
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  9. S. Brandner
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Correspondence to I. Fiss.

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Conflict of interest

UWT is consultant for Miethke Company and receives lecture honorarium from B. Braun-Aesculap Company. Author IF declares that he has no conflict of interest. Author MV declares that she has no conflict of interest. Author CVDB declares that he has no conflict of interest. Author CB declares that he has no conflict of interest. Author NH declares that he has no conflict of interest. Author FF declares that he has no conflict of interest. Author VR declares that he has no conflict of interest. Author SB declares that he has no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Fiss, I., Vanderheyden, M., von der Brelie, C. et al. In vitro performance of combinations of anti-siphon devices with differential pressure valves in relation to the spatial position. Acta Neurochir 162, 1033–1040 (2020). https://doi.org/10.1007/s00701-020-04228-6

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  • DOI: https://doi.org/10.1007/s00701-020-04228-6

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