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Neurosurgery
Gravitational valves improve patient outcomes
MIETHKE gravitational shunts offer special protection to avoid position-dependent complications such as over- and underdrainage, with positive clinical outcomes for the patient and a significant reduction of overdrainage events. [1-4]
All MIETHKE valves are manufactured with high precision from titanium and are protected against unintentional reprogramming by magnetic fields of up to 3 Tesla. [5]
Advances in shunt technology, in particular adjustable and gravitational valves, have improved patient outcomes. [6-7] Finding the best possible patient-individual pressure setting and assessing shunt function can however be challenging and time-consuming. M.scio® is a telemetric pressure sensor approved for permanent implantation. Valve adjustments following telemetric read-out of the pressure via the M.scio® improve outcomes in most patients and knowledge of the pressure can help to avoid unnecessary hospitalizations, investigations, and radiation exposure. [6-8]
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[1] Tschan CA, Antes S, Huthmann A, et al. Overcoming CSF overdrainage with the adjustable gravitational valve proSA. Acta Neurochir (Wien). 2014;156(4):767-76; discussion 776.
[2] Suchorska B, Kunz M, Schniepp R, et al. Optimized surgical treatment for normal pressure hydrocephalus: comparison between gravitational and differential pressure valves. Acta Neurochir (Wien). 2015;157(4):703-9.
[3] Lemcke J, Meier U, Muller C, et al. Safety and efficacy of gravitational shunt valves in patients with idiopathic normal pressure hydrocephalus: a pragmatic, randomised, open label, multicentre trial (SVASONA). J Neurol Neurosurg Psychiatry. 2013;84(8):850-7
[4] Sprung C, Schlosser HG, Lemcke J, et al. The adjustable proGAV shunt: a prospective safety and reliability multicenter study. Neurosurgery. 2010;66(3):465-74.
[5] Chari A, Czosnyka M, Richards HK, Pickard JD, Czosnyka ZH. Hydrocephalus shunt technology: 20 years of experience from the Cambridge Shunt Evaluation Laboratory. J Neurosurg. 2014;120(3):697-707.
[6] Antes S, Stadie A, Muller S, et al. Intracranial Pressure-Guided Shunt Valve Adjustments with the Miethke Sensor Reservoir. World Neurosurg. 2018;109:e642-e50.
[7] Freimann FB, Schulz M, Haberl H, et al. Feasibility of telemetric ICP-guided valve adjustments for complex shunt therapy. Childs Nerv Syst. 2014;30(4):689-97.
[8] Thompson S, Thorne L, Toma A, et al. Telemetric monitoring of ICP within a shunt system. A single centre experience including the first in vivo comparison versus conventional intraparenchymal monitoring. Fluids and Barriers of the CNS. 2017;14(Suppl 1):A63.
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