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  • Lumboperitoneal, ventriculoperitoneal shunting for IIH show comparable failure rates

    Neuro-Ophthalmology/Orbit

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    Review of: Lumboperitoneal and Ventriculoperitoneal Shunting for Idiopathic Intracranial Hypertension Demonstrate Comparable Failure and Complication Rates

    Azad T, Zhang Y, Varshneya K, et al. Neurosurgery, February 2020

    This retrospective study compared the postoperative outcomes of lumboperitoneal (LP) and ventriculoperitoneal (VP) shunts for management of idiopathic intracranial hypertension (IIH).

    Study design

    Using a national administrative database, researchers identified 347 patients who received a LP shunt placement and 735 who received a VP shunt between 2007 and 2014. The primary outcome was shunt failure. Secondary outcomes included number of shunt failures, time to first failure, complication rates and readmission rates.

    Outcomes

    Rates of shunt failure were similar among patients with LP and VP shunts (35% vs. 32%; P=0.382). Ninety-day readmission rates, complication rates and costs did not significantly differ between groups. The authors noted that patients who experienced more than 2 shunt failures tended to have an earlier time to first shunt failure (HR 1.41).

    Limitations

    This study is limited by its retrospective study design.

    Clinical significance

    The choice of the type of shunt (VP versus LP) is often deferred to the neurosurgeon based on individual preference and outcomes. This study suggests that outcomes in patients with IIH may be similar regardless of shunt type. The results show that LP and VP shunts have comparable rates of shunt failure and complication and that earlier time to first shunt failure may be associated with multiple shunt failures.