Endovascular Shunting for Communicating Hydrocephalus Using a Biologically Inspired Transdural Cerebrospinal Fluid Valved eShunt® Implant

• Published in: Neurosurgery clinics of North America Vol. 35; no. 3; pp. 379 - 387
• Main Authors: Malek, Adel M., Beneduce, Brandon M., Heilman, Carl B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2024
• Subjects: Arachnoid granulations; Cerebrospinal fluid; Cerebrospinal Fluid Shunts - adverse effects; Cerebrospinal Fluid Shunts - instrumentation; Cerebrospinal Fluid Shunts - methods; Endovascular Procedures - instrumentation; Endovascular Procedures - methods; Endovascular shunting; eShunt® Implant; Humans; Hydrocephalus; Hydrocephalus - surgery; eShunt® Implant; Cerebrospinal fluid; Hydrocephalus; Endovascular shunting; Arachnoid granulations
• ISSN: 1042-3680; 1558-1349
• DOI: 10.1016/j.nec.2024.03.004

Cerebrospinal fluid (CSF) bathing the central nervous system is produced by brain and choroid plexus within the ventricles for re-absorption into the venous circulation through arachnoid granulations (AG). Communicating hydrocephalus results from disruption of the absorptive process, necessitating surgical catheter-based shunt placement to relieve excess pressure from CSF buildup. Adjustable valve designs and antibiotic impregnation have minimally impacted persistent failure rates and postoperative complications. To confront this challenge, we have developed an innovative endovascular shunt implant biologically inspired from AG function to restore the natural dynamics of CSF drainage while concurrently addressing the predominant factors contributing to conventional shunt malfunction.