title: Risk factors associated with distal catheter migration following ventriculoperitoneal shunt placement.
abstract: Ventriculoperitoneal (VP) shunt placement is used to treat hydrocephalus. Shunt migration following VP shunt placement has been reported. The risk factors related to this complication have not been previously evaluated to our knowledge. In this retrospective cohort study, we aimed to determine risk factors leading to distal catheter migration and review the literature on the current methods of management and prevention. Adult patients undergoing VP shunt placement from June 2011 to December 2013 at a single institution were identified using electronic health records. The records were reviewed for demographic and procedural information, and subsequent treatment characteristics. The parameters of patients with distal shunt migration were compared to those undergoing new VP shunt placement for the same time period. We identified 137 patients undergoing 157 new VP shunt procedures with an average age of 57.7 ± standard deviation of 18.4 years old. There were 16 distal shunt migrations. Body mass index >30 kg/m(2) and number of previous shunt procedures were found to be independent risk factors for distal catheter migration. Obesity and number of previous shunt procedures were factors for distal catheter migration. Providers and patients should be aware of these possible risk factors prior to VP shunt placement.
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA. Electronic address: kingsley-abode-iyamah@uiowa.edu.
authors.forename: Kingsley O
authors.initials: KO
authors.lastname: Abode-Iyamah
authors.affiliation: Department of Neurosurgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Khanna
authors.affiliation: The University of Iowa, Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Zachary D
authors.initials: ZD
authors.lastname: Rasmussen
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
authors.forename: Oliver
authors.initials: O
authors.lastname: Flouty
authors.affiliation: Department of Neurosurgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Nader S
authors.initials: NS
authors.lastname: Dahdaleh
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Greenlee
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, The University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Howard
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002408:Catheters, Indwelling; D019468:Disease Management; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009765:Obesity / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*; D055815:Young Adult
keywords: Distal shunt revision; Shunt complication; Shunt malfunction; Shunt migration; Shunt revision; VP shunt