Laboratory evaluation of the phoenix CRx diamond valve.
OBJECTIVE
To assess the long-term hydrodynamic properties of a new cerebrospinal fluid flow-regulating hydrocephalus shunt called the CRx Diamond valve (Phoenix Biomedical Corp., Valley Forge, PA).


METHODS
Three samples of a Diamond valve were tested in the United Kingdom Shunt Evaluation Laboratory during a 40-day period. Tests were performed for long-term pressure-flow performance, overdrainage, susceptibility to ambient temperature changes, external pressure, reflux, presence of small particles in the reagent, mechanical durability, and magnetic resonance imaging compatibility.


RESULTS
Tests demonstrated that the Diamond valve stabilized flow within the range of 0.36 to 0.62 ml/min when pressure varied from 14 to 23 mm Hg. Hydrodynamic resistance demonstrated pressure-dependent variability from 20 to 78 mm Hg/(ml/min). The time drift of hydrodynamic parameters was significant (P < 0.001). The valve was insensitive to changes in temperature, external pressure, rapid fluctuations of differential pressure, small particles in fluid, and reflux.


CONCLUSIONS
The Diamond valve demonstrated the intended variable resistance, which increased as the pressure increased. This property may help it limit overdrainage related to body posture as well as nocturnal vasogenic waves. Flow through the valve stabilizes within a wide range, which may contribute to the prevention of excessive pressure buildup after implantation. However, shunt placement should be avoided in patients who present with normal baseline intracranial pressure but an increased incidence of high vasogenic intracranial pressure waves.
United Kingdom Shunt Evaluation Laboratory, Academic Neurosurgical Unit, Addenbrooke's Hospital, Cambridge, England. zc200@medschl.cam.ac.uk
Z H
ZH
Czosnyka
M
M
Czosnyka
H K
HK
Richards
J D
JD
Pickard
D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation*; D004867:Equipment Design; D012212:Rheology