Economic Analysis of Endoscopic Third Ventriculostomy and Ventricular Shunts
Endoscopic third ventriculostomy (ETV) is the principal alternative therapy to shunt placement. Fueled by the persistent complications associated with CSF shunt placement and aided by the development of new instruments and better optical and video systems, ETV is becoming performed routinely in the management of hydrocephalus. However, not all patients with hydrocephalus are candidates for this procedure (see Chap. 25). As ETV has become more routinely performed, attempts to determine an optimal strategy for integration of this new technology into the management of hydrocephalus have focused primarily on identifying the subpopulation of patients in whom the procedure is “most effective” in eliminating the need for shunt placement. In selecting patients for ETV on clinical grounds, one weighs the obvious benefits of remaining or becoming shunt-free against the added risk of the procedure itself and, if it is unsuccessful, the added inconvenience and risk of a second surgical procedure for placement of a shunt.
KeywordsEndoscopic Third Ventriculostomy Shunt Infection Shunt Placement Shunt Revision Aqueductal Stenosis
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