Surgical ventriculoperitoneal shunting remains standard treatment for communicating hydrocephalus, despite significant infection and revision rates. A new minimally-invasive endovascular cerebrospinal fluid shunt has been developed (CereVasc eShunt™) to mimic arachnoid granulation function. This implant is intended to be deployed via femoral transvenous approach across the inferior petrosal sinus dura mater into the cerebellopontine angle cistern. We hereby present the first patient to be treated using this approach. An 84-year-old woman with intractable hydrocephalus following subarachnoid hemorrhage underwent an external ventricular drain clamping which was not tolerated owing to intracranial pressure (ICP) reaching 44cmH­₂O. On the following day, her drain was clamped eight hours prior to undergoing successful endovascular deployment of the eShunt device with post-implant CT head showing no hemorrhage. Within 90 mins of eShunt insertion, the patient’s ICP decreased from 38 to <20 cmH₂O to followed by subsequent resolution of ventriculomegaly. This is the first patient treated for communicating hydrocephalus using a novel endovascular CSF shunt without the need for a burr hole, brain penetration or multiple skin incisions. This novel and unique percutaneous transluminal access to the central nervous system ushers a new pathway for non-invasive treatment of hydrocephalus and potential for percutaneous access to the central nervous system for intervention against neurological disorders.

Disclosures P. Lylyk: 1; C; Cerevasc. I. Lylyk: None. C. Bleise: None. J. Lundquist: None. E. Scrivano: None. B. Beneduce: 5; C; Employee Cerevasc. C. Heilman: 4; C; Stockholder. A. Malek: 4; C; Stockholder.