title: The retrograde ventriculo-sinus shunt (El Shafei RVS shunt). Rationale, evolution, surgical technique and long-term results.
abstract: Since 1990, 110 retrograde ventriculo-sinus (RVS) shunts were implanted; 98 patients (89.1%) benefited - 1 of them (0.9%) after shunt revision. The manifestations of high intra cranial pressure (ICP) disappeared, there were no problems related to improper cerebrospinal fluid (CSF) drainage, and the transcranial Doppler (TCD) resistive index (RI) measurements decreased to within normal ranges. Radiologically, the ventriculomegaly showed no regression in patients with open craniums and variable degrees of mild regression in patients with rigid craniums. Complications that needed shunt removal or revision occurred in 13 patients (11.8%); 1 patient (0.9%) died before shunt revision; they were all due to technical errors committed during the stages of evolution of the surgical technique for shunt implantation. The follow-up ranged between 4 months and 11 years (mean 3.42 years).
  
  
  CONCLUSIONS
  the RVS shunt is a simple, minimally invasive, physiological procedure for treatment of hydrocephalus and is suitable for all ages.
authors.affiliation: Department of Neurosurgery, Manial University Hospital, Cairo University, Cairo, Egypt.
authors.forename: Ismail L
authors.initials: IL
authors.lastname: El Shafei
authors.forename: Hassan I
authors.initials: HI
authors.lastname: El Shafei
mesh_terms: D000293:Adolescent; D000328:Adult; D002552:Cerebral Ventricles / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003392:Cranial Sinuses / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome