One-Year Shunt-Free Survival after Secondary Endoscopic Third Ventriculostomy (ETV) for Shunt Malfunction: Insights from a Tertiary Care Center in a Resource-Constrained Setting

Objectives: To assess the one-year shunt-free survival rate in patients undergoing secondary ETV for shunt failure. Materials & Methods: This retrospective study is done to evaluate the one-year shunt-free outcomes of secondary endoscopic third ventriculostomy (ETV) in 32 patients who presented with ventriculoperitoneal (VP) shunt malfunction due to obstructive hydrocephalus in a tertiary care hospital. Post-operative clinical features of raised intracranial pressure and shunt malfunctions were assessed for one year. MRI or CT scan and a history of shunt revision/insertion during the follow-up period were also noted. Results: We had 32 patients in our study 17 males (53.1%) and 15 females (46.9%) with shunt malfunction treated by secondary ETV. The mean age at the time of ETV was 12 years with standard deviations ranging from 0.7 to 15 years. The one-year shunt revision-free survival rate was 68.8%. No major complications occurred in patients after the endoscopic procedures. Conclusion: Results show a significant success rate in achieving shunt-free outcomes, especially in younger patients, favoring, secondary ETV as a viable option as compared to shunt revision. Keywords: Endoscopy, Hydrocephalus, Ventriculoperitoneal Shunt, shunt failure, Ventriculostomy