Maset Angelo Luiz, Suriano Ltalo Capraro, Monteiro Ruy, Pinto José Ricardo Camilo, de Andrade José Ricardo, Mancini Bruna Monieli, Ramin Sérgio Luiz, Moraes Dionei Freitas, Cavalheiro Sérgio
Department of Neurosurgery, FUNFARME, São José do Rio Preto, SP; Founder and Owner for Ventura Biomedica Ltda, Brazil.
São Paulo Federal University, São Paulo, SP, Brazil.
Surg Neurol Int. 2014 Aug 22;5:130. doi: 10.4103/2152-7806.139410. eCollection 2014.
Ventriculoperitoneal shunts are supplied with long peritoneal catheters, most commonly between 80 and 120 cm long. ISO/DIS 7197/2006([15]) shunt manufacturing procedures include peritoneal catheter as an integrate of the total resistance. Cutting pieces of peritoneal catheters upon shunt implantation or revision is a common procedure.
We evaluated five shunts assembled with different total pressure resistances and variable peritoneal catheter lengths in order to clarify the changes that occurred in the hydrodynamic profile when peritoneal catheters were cut upon shunt implantation or shunt revision.
Originally, all shunts performed within the operational range. Shunt 1 performed in a lower pressure range at 200 mm cut off peritoneal catheter and as a low-pressure shunt with -300 mm cut off. Shunt 2 was manufactured to run at the higher border pressure range, and it went out of specification with a 300 mm cut off. Shunt 3 was manufactured to run close to the lower border pressure range, and at 100 mm cutoff, it was already borderline in a lower resistive category. Other shunts also responded similarly.
The limit to maintain a shunt in its original pressure settings was 20 cm peritoneal catheter cutting length. By cutting longer pieces of peritoneal catheter, one would submit patients to a less-resistive regimen than intended and his reasoning will be compromised. The pediatric population is more prone to suffer from the consequences of cutting catheters. Shunt manufacturers should consider adopting peritoneal catheters according to the age (height) of the patient.
脑室腹腔分流管配有长的腹膜导管，最常见的长度在80至120厘米之间。ISO/DIS 7197/2006([15])分流管制造程序将腹膜导管作为总阻力的一个组成部分。在分流管植入或翻修时切割腹膜导管片段是一种常见的操作。
我们评估了五根组装有不同总压力阻力和可变腹膜导管长度的分流管，以阐明在分流管植入或分流管翻修时切割腹膜导管时流体动力学轮廓发生的变化。
最初，所有分流管都在操作范围内运行。分流管1在腹膜导管截断200毫米时在较低压力范围内运行，截断300毫米时作为低压分流管运行。分流管2设计为在较高边界压力范围内运行，截断300毫米时超出规格。分流管3设计为在接近较低边界压力范围内运行，截断100毫米时，它已经处于较低阻力类别的临界状态。其他分流管也有类似反应。
将分流管维持在其原始压力设置的极限是腹膜导管切割长度为20厘米。通过切割更长的腹膜导管片段，患者将接受比预期阻力更小的治疗方案，其合理性将受到影响。儿科人群更容易受到切割导管后果的影响。分流管制造商应考虑根据患者的年龄（身高）采用腹膜导管。
