title: Addressing the siphoning effect in new shunt designs by decoupling the activation pressure and the pressure gradient across the valve.
abstract: OBJECTIVE
  Although several improvements have been observed in the past few years in shunt technology, currently available systems still present several associated problems. Among these, overdrainage along with its complications remains one of the great challenges for new shunt designs. To address the so-called siphoning effect, the authors provide a practical example of how it is possible to decouple the activation pressure and the pressure gradient across the valve through a 3-key component system. In this new shunt design, the flow is expected to depend only on the intracranial pressure and not on the pressure gradient across the valve, thus avoiding the so-called siphoning effect.
  
  
  METHODS
  The authors used computer models to theoretically evaluate the mechanical variables involved in the operation of the newly designed valve, such as the fluid's Reynolds number, proximal pressure, distal pressure, pressure gradient, actual flow rate, and expected flow rate. After fabrication of the first superscaled model, the authors performed benchmark tests to analyze the performance of the new shunt prototype, and the obtained data were compared with the results predicted by the previous mathematical models.
  
  
  RESULTS
  The final design of the new paddle wheel valve with the 3-key component antisiphoning system was tested in the hydrodynamics laboratory to prove that the siphoning effect did not occur. According to the calculations obtained using the LabVIEW program during the experiments, each time the distal pressure decreased without an increase in the proximal pressure (despite the range of the pressure gradient), the pin blocked the spinning of the paddle wheels, and the calculated fluid velocity through the system tended to zero. Such a situation was significantly different from the expected flow rate for such a pressure gradient in a siphoning situation without the new antisiphon system.
  
  
  CONCLUSIONS
  The design of this new prototype with a 3-key component antisiphoning system demonstrated that it is possible to decouple the activation pressure and the pressure gradient across the valve, avoiding the siphoning effect. Although further developments are necessary to provide a model compatible to clinical use, the authors believe that this new prototype illustrates the possibility of successfully addressing the siphoning effect by using a simple 3-key component system that is able to decouple the activation pressure and the pressure gradient across the valve by using a separate pressure chamber. It is expected that such proof of concept may significantly contribute to future shunt designs attempting to address the problem of overdrainage due to the siphoning effect.
authors.affiliation: Department of Neurosurgery, Illinois Neurological Institute, The University of Illinois College of Medicine at Peoria, Peoria, Illinois 61637, USA. tobias.a.mattei@osfhealthcare.org
authors.forename: Tobias A
authors.initials: TA
authors.lastname: Mattei
authors.forename: Martin
authors.initials: M
authors.lastname: Morris
authors.forename: Kathleen
authors.initials: K
authors.lastname: Nowak
authors.forename: Daniel
authors.initials: D
authors.lastname: Smith
authors.forename: Jeremy
authors.initials: J
authors.lastname: Yee
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Goulart
authors.forename: Anne
authors.initials: A
authors.lastname: Zborowski
authors.forename: Julian J
authors.initials: JJ
authors.lastname: Lin
mesh_terms: D002555:Cerebrospinal Fluid; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation* / Q000379:methods; D003198:Computer Simulation; D004867:Equipment Design; D006801:Humans; D006849:Hydrocephalus / Q000503:physiopathology* / Q000601:surgery*; D057446:Hydrodynamics; D007427:Intracranial Pressure