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Investigation of the hydrodynamic properties of a new MRI-resistant programmable hydrocephalus shunt.

Allin DM, Czosnyka M, Richards HK, Pickard JD, Czosnyka ZH - Cerebrospinal Fluid Res (2008)

Bottom Line: External programming proved to be easy and reliable.The Polaris Valve is a reliable, adjustable valve.Unlike other adjustable valves (except the Miethke ProGAV valve), the Polaris cannot be accidentally re-adjusted by an external magnetic field.

View Article: PubMed Central - HTML - PubMed

Affiliation: Shunt Evaluation Laboratory & Academic Neurosurgical Unit, Addenbrooke's Hospital, P,O, Box 167, Hills Road, Cambridge CB2 2QQ, UK. mc141@medschl.cam.ac.uk.

ABSTRACT

Background: The Polaris valve is a newly released hydrocephalus shunt that is designed to drain cerebrospinal fluid (CSF) from the brain ventricles or lumbar CSF space. The aim of this study was to bench test the properties of the Polaris shunt, independently of the manufacturer.

Methods: The Polaris Valve is a ball-on-spring valve, which can be adjusted magnetically in vivo. A special mechanism is incorporated to prevent accidental re-adjustment by an external magnetic field. The performance and hydrodynamic properties of the valve were evaluated in the UK Shunt Evaluation Laboratory, Cambridge, UK.

Results: The three shunts tested showed good mechanical durability over the 3-month period of testing, and a stable hydrodynamic performance over 45 days. The pressure-flow performance curves, operating, opening and closing pressures were stable. The drainage rate of the shunt increased when a negative outlet pressure (siphoning) was applied. The hydrodynamic parameters fell within the limits specified by the manufacturer and changed according to the five programmed performance levels. Hydrodynamic resistance was dependant on operating pressure, changing from low values of 1.6 mmHg/ml/min at the lowest level to 11.2 mmHg/ml/min at the highest performance level. External programming proved to be easy and reliable. Even very strong magnetic fields (3 Tesla) were not able to change the programming of the valve. However, distortion of magnetic resonance images was present.

Conclusion: The Polaris Valve is a reliable, adjustable valve. Unlike other adjustable valves (except the Miethke ProGAV valve), the Polaris cannot be accidentally re-adjusted by an external magnetic field.

No MeSH data available.


Related in: MedlinePlus

Superimposed pressure-flow curves taken from 10 tests utilizing one shunt at 70 mmH2O (5.2 mmHg). The scatter of the measurement points indicates good agreement over repeated measurements.
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Figure 5: Superimposed pressure-flow curves taken from 10 tests utilizing one shunt at 70 mmH2O (5.2 mmHg). The scatter of the measurement points indicates good agreement over repeated measurements.

Mentions: A typical pressure-flow curve with pressure plotted along the x-axis and flow along the y-axis, is shown in Figure 4. The valve without a distal catheter, and with no pulsatile pressure wave, had slightly non-linear characteristics. The hydrodynamic static resistance was equivalent to the inverse of the gradient. Composite pressure-flow curves (10 tests in 3 valves) from one valve are presented in Figure 5 as flow versus pressure.


Investigation of the hydrodynamic properties of a new MRI-resistant programmable hydrocephalus shunt.

Allin DM, Czosnyka M, Richards HK, Pickard JD, Czosnyka ZH - Cerebrospinal Fluid Res (2008)

Superimposed pressure-flow curves taken from 10 tests utilizing one shunt at 70 mmH2O (5.2 mmHg). The scatter of the measurement points indicates good agreement over repeated measurements.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2365935&req=5

Figure 5: Superimposed pressure-flow curves taken from 10 tests utilizing one shunt at 70 mmH2O (5.2 mmHg). The scatter of the measurement points indicates good agreement over repeated measurements.
Mentions: A typical pressure-flow curve with pressure plotted along the x-axis and flow along the y-axis, is shown in Figure 4. The valve without a distal catheter, and with no pulsatile pressure wave, had slightly non-linear characteristics. The hydrodynamic static resistance was equivalent to the inverse of the gradient. Composite pressure-flow curves (10 tests in 3 valves) from one valve are presented in Figure 5 as flow versus pressure.

Bottom Line: External programming proved to be easy and reliable.The Polaris Valve is a reliable, adjustable valve.Unlike other adjustable valves (except the Miethke ProGAV valve), the Polaris cannot be accidentally re-adjusted by an external magnetic field.

View Article: PubMed Central - HTML - PubMed

Affiliation: Shunt Evaluation Laboratory & Academic Neurosurgical Unit, Addenbrooke's Hospital, P,O, Box 167, Hills Road, Cambridge CB2 2QQ, UK. mc141@medschl.cam.ac.uk.

ABSTRACT

Background: The Polaris valve is a newly released hydrocephalus shunt that is designed to drain cerebrospinal fluid (CSF) from the brain ventricles or lumbar CSF space. The aim of this study was to bench test the properties of the Polaris shunt, independently of the manufacturer.

Methods: The Polaris Valve is a ball-on-spring valve, which can be adjusted magnetically in vivo. A special mechanism is incorporated to prevent accidental re-adjustment by an external magnetic field. The performance and hydrodynamic properties of the valve were evaluated in the UK Shunt Evaluation Laboratory, Cambridge, UK.

Results: The three shunts tested showed good mechanical durability over the 3-month period of testing, and a stable hydrodynamic performance over 45 days. The pressure-flow performance curves, operating, opening and closing pressures were stable. The drainage rate of the shunt increased when a negative outlet pressure (siphoning) was applied. The hydrodynamic parameters fell within the limits specified by the manufacturer and changed according to the five programmed performance levels. Hydrodynamic resistance was dependant on operating pressure, changing from low values of 1.6 mmHg/ml/min at the lowest level to 11.2 mmHg/ml/min at the highest performance level. External programming proved to be easy and reliable. Even very strong magnetic fields (3 Tesla) were not able to change the programming of the valve. However, distortion of magnetic resonance images was present.

Conclusion: The Polaris Valve is a reliable, adjustable valve. Unlike other adjustable valves (except the Miethke ProGAV valve), the Polaris cannot be accidentally re-adjusted by an external magnetic field.

No MeSH data available.


Related in: MedlinePlus