success rates and complications of ventriculoperitoneal and ventriculoatrial shunting: a systematic review

Background and aim: the insertion of ventriculoperitoneal (vp) or ventriculoatrial (va) shunt isthe first line of treatment in patients with hydrocephalus and normal-pressure hydrocephalus.the provision of a safety profile for shunting in the treatment of hydrocephalus patients is veryimportant. this study aimed to determine the success rates and complications of vp and vashunting in patients with hydrocephalus.methods and materials/patients: this systematic review investigated the complication rates of vpand va shunting in managing patients with hydrocephalus. all the published studies were searchedin three electronic databases of web of science, pubmed and google scholar from march 20 toapril 10, 2020, using the keywords of “ventriculoperitoneal” and “ventriculoatrial” in combinationwith “hydrocephalus”.results: in total, nine articles met the eligibility criteria for being included in this review. somestudies showed a higher rate of shunt obstruction in patients undergoing va shunting; however,other studies demonstrated no difference in terms of shunt obstruction. the rates of primaryrevision shunt were various within the ranges of 5.4%-48% and 9.1%-58% for va and vp shunting,respectively. a higher rate of revision shunt was reported among the patients undergoing vpshunting, compared to that reported for va shunting. the different mortality rates in various studieswere estimated within the range of 0%-10% and at 13.9% for va and vp shunting, respectively.conclusion: in general, no difference was reported between va and vp shunting regarding therates of complications and mortality. due to the ease of placement and revision, vp shuntingcould be considered the first-line treatment of hydrocephalus. however, this approach has beenpreferred in newborns, and there have been insufficient data on adults in this regard.