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首页> 外文期刊>Fluids and Barriers of the CNS >Initial experience with the Codman Certas adjustable valve in the management of patients with hydrocephalus
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Initial experience with the Codman Certas adjustable valve in the management of patients with hydrocephalus

机译：Codman Certas可调瓣膜治疗脑积水的初步经验

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Background A new adjustable valve, the Codman CertasTM valve for treatment of hydrocephalus was introduced into clinical practice in January 2011. It has 8 different settings with an opening pressure varying from 36 to over 400?mm H2O at a flow rate of 20?mL/h. The 8th setting is designed to provide a "virtual off" function. The objective of this report is to describe the initial clinical experience with the CertasTM valve and evaluate clinical usage with the main focus on the portable adjustment device - Therapeutic Management System (TMS), the “virtual off” setting and compatibility with magnetic resonance imaging (MRI). Findings Forty-two patients with hydrocephalus from different etiologies were treated with the CertasTM adjustable shunt system. Data regarding implantation procedures, the use of the TMS system, x-ray imaging, and MRI procedures were recorded prospectively. All patients had clinical follow-up at four weeks after implantation and every three months until a stable clinical condition was obtained. The mean time for follow-up was 8.6?months (1–16.6). Seventy-one adjustments were performed with the TMS, 12 were problematic. Twenty-nine MRI procedures were performed and did not cause accidental resetting. Five patients were treated with the "virtual off" function for a period. Conclusions We found the CertasTM valve valuable in the treatment of hydrocephalus, usability of the TMS was high because it is small and portable, but in some cases we experienced adjustment problems with the first procedures performed by a surgeon, indicating that there is a learning curve. The "virtual off" function provided a possibility of treating over-drainage without the need for shunt ligation or other invasive procedures.
机译：背景技术2011年1月，一种新的可调节阀，用于治疗脑积水的Codman CertasTM阀被引入临床实践。它具有8种不同的设置，打开压力从36至超过400？mm H2O，流速为20？mL / H。第8个设置旨在提供“虚拟关闭”功能。本报告的目的是描述CertasTM瓣膜的初步临床经验，并评估临床使用情况，主要侧重于便携式调节装置-治疗管理系统（TMS），“虚拟关闭”设置以及与磁共振成像的兼容性（ MRI）。研究结果用CertasTM可调分流系统治疗了来自不同病因的42例脑积水患者。前瞻性地记录了有关植入程序，TMS系统的使用，X射线成像和MRI程序的数据。所有患者在植入后四周和每三个月进行一次临床随访，直至获得稳定的临床状况。平均随访时间为8.6个月（1-16.6）。使用TMS进行了71次调整，其中12次有问题。进行了29项MRI检查，没有引起意外复位。五名患者接受了“虚拟关闭”功能治疗一段时间。结论我们发现CertasTM瓣膜对脑积水的治疗很有价值，因为TMS体积小且便于携带，因此TMS的可用性很高，但是在某些情况下，我们在外科医生的首次手术中遇到了调整问题，这表明存在学习曲线。 “虚拟关闭”功能提供了无需分流结扎或其他侵入性程序即可治疗过度引流的可能性。

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