Complications of INA-Shunt® Insertion in Pediatric Patients with Hydrocephalus and its Variations

Abstract

Purpose: Hydrocephalus is characterized by an abnormal accumulation of cerebrospinal fluid (CSF), often necessitating treatment with a Ventriculoperitoneal Shunt (VP Shunt). Indonesia has introduced its own VP Shunt system, the INA-shunt. This study aims to assess complications associated with the INA Shunt system in paediatric hydrocephalus patients and identify influencing factors.

Materials and Methods: This multicentre retrospective study (January 2018 - December 2019) included 31 eligible subjects from Dr. Cipto Mangunkusumo General Hospital, Harapan Kita Hospital, and Sardjito Hospital. Complications were evaluated through clinical and radiological assessments within 1-year post-surgery.

Results: Among 31 subjects, 5 (16%) experienced complications: proximal shunt malfunction (10%, n=3), exposed shunt (3%, n=1), and infected shunt (3%, n=1). No subdural haemorrhages occurred. Most complications arose in patients ≤ 3 months old at VP shunt placement, with 80% within < 6 months post-surgery. No significant relationship emerged between subject characteristics and INA shunt pump-related complications.

Complications were observed in 5 out of 31 subjects (16%). These complications included proximal shunt malfunction (10%, n=3), exposed shunt (3%, n=1), and infected shunt (3%, n=1), with no incidents of subdural haemorrhage. All complications occurred in patients ≥ 3 months of age at the time of VP Shunt surgery, with 80% arising within 6 months post-surgery. No significant correlations were found between subject characteristics and postoperative VP shunt complications using the INA shunt pump.

Conclusion: The VP Shunt operation using the INA Shunt pump system exhibits a minimal and tolerable complication rate, supporting its use in paediatric hydrocephalus patients with various presentations.