Predictors of the degree of ventricular catheter obstruction: duration of implantation, number of prior revision surgeries, contact with the ventricular wall and the surgical approach

Abstract Background Ventricular catheters (VCs) used to manage hydrocephalus are prone to failure due to blockages from tissue aggregates. In this study, the authors explored how clinical factors, specifically the number of prior revision surgeries and the duration of implantation affected the degree of VC obstruction and failure rates. Methods A previously described biobank and its associated clinical data was used for this analysis. Each hole on the VCs was classified by degree of tissue obstruction after macroscopic analysis. Univariate and multivariate and binned analyses were conducted to test for associations between clinical data and degree of VC obstruction. Results VC holes obstructed by protruding tissue aggregates were positively correlated with fewer previous revisions (p < 0.05). Longer duration of VC implantation was associated with more holes with occlusions and protruding tissue aggregates (p < 0.05). VCs implanted for < 3 months had a fewer number of holes obstructed by protruding tissue aggregates than VCs implanted for 13 + months (p < 0.05). VCs contacting the ventricular wall were more likely to have a significantly greater number of holes with occlusions and protruding tissue aggregates (p < 0.005). VCs with no contact with the ventricular wall were more likely to be unoccluded (p = 0.005). VCs implanted using the occipital approach were associated with greater number of holes with protruding tissue aggregates (p < 0.05). Conclusion Number of prior revisions and duration of implantation are both factors that correlate with the degree of VC obstruction. Additionally, contact of the VC with the ventricular wall and the surgical approach during implantation are robust predictors of the number of obstructed holes.