Hydrodynamics of the Certas™ programmable valve for the treatment of hydrocephalus

Anders Eklund, Lars Owe D. Koskinen, Michael A. Williams, Mark G. Luciano, Stephen M. Dombrowski, Jan Malm

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The new Certas™ shunt for the treatment of hydrocephalus has seven standard pressure settings that according to the manufacturer range from 36 to 238 mmH 2O, and an additional " Virtual Off" setting with an opening pressure >400 mmH 2O. Information on actual pressure response and reliability of shunt performance is important in clinical application, especially the " Virtual Off" setting as a non-surgical replacement for shunt ligation. The objective of this study was to evaluate the in-vitro hydrodynamic performance of the Certas™ shunt.Methods: Six new Certas™ shunts with proximal and distal catheters were tested with an automated, computerized test system that raised the pressure from zero to a maximum pressure and back to zero at each valve setting. Opening pressure and flow resistance were determined.Results: For settings 1-7 the measured opening pressure range was 26 to 247 mmH 2O, and the mean change in opening pressure for a one-step adjustment was between 33 and 38 mmH 2O. For setting 8 (" Virtual Off" ) the measured mean opening pressure was 494 ± 34 mmH 2O (range 451 to 556 mmH 2O). The mean outflow resistance was 7.0 mmHg/ml/min (outflow conductance 17.9 μl/s/kPa).Conclusions: The six shunts had similar characteristics and closely matched the manufacturer's specifications for opening pressure at settings 1-7. The opening pressure for the " Virtual Off" setting was nearly 500 mmH 2O, which is 100 mmH 2O higher than the manufacturer's specification of " >400" and should be functionally off for most patients with communicating hydrocephalus. Clinical studies are needed to evaluate if the CSF dynamic profile persists after implantation in patients.

Original languageEnglish (US)
Article number12
JournalFluids and barriers of the CNS
Volume9
Issue number1
DOIs
StatePublished - May 29 2012
Externally publishedYes

Keywords

  • Cerebrospinal fluid
  • Conductance
  • Csf
  • Hydrocephalus
  • Intracranial pressure
  • Normal pressure hydrocephalus
  • Outflow resistance
  • Shunt

ASJC Scopus subject areas

  • Neurology
  • Developmental Neuroscience
  • Cellular and Molecular Neuroscience

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