Article Text

Download PDFPDF

P117/179  Treatment of normal pressure hydrocephalus using the eShunt endovascular transvenous implant
  1. Lylyk Pedro1,
  2. Charles Matouk2,
  3. Adnan Siddiqui3,
  4. Ivan Lylyk1,
  5. Carlos Bleise1,
  6. Esteban Scrivano1,
  7. Pedro Nicolas Lylyk1,
  8. Antonio Joseph2,
  9. Beneduce Brandon4,
  10. Levy Elad3,
  11. Carl Heilman1,
  12. Adel Malek5
  1. 1Interventional Neuroradiology ENERI/Clinica La Sagrada Familia,, Buenos Aires, Argentina
  2. 2Yale-New Haven Hospital, New Haven, USA
  3. 3SUNY Buffalo/Neurosurgery, Buffalo, USA
  4. 4CerVasc Inc., Auburndale, USA
  5. 5Tufts Medical Center, Neurosurgery, Boston, USA


Introduction Idiopathic Normal Pressure Hydrocephalus (NPH) is a reversible form of dementia typically treated with ventriculo-peritoneal shunt surgery. Recently we have described the first percutaneous transfemoral transvenous deployment of an endovascular CSF shunt (eShunt® System; CereVasc, Inc., Auburndale, MA, USA) to treat communicating hydrocephalus.

Aim of Study We sought to evaluate the response of NPH to endovascular eShunt implant deployment in an initial multi-center clinical pilot trial using gait, bladder and cognitive outcome measures.

Methods Patients were included after demonstrating >20% gait improvement in lumbar drainage trial. Gait was assessed using Timed Up & Go (TUG) test, cognition using Montreal cognitive assessment (MoCA), and urinary incontinence using Neurogenic Bladder Symptom Score (NBSS). Results were normalized per-patient to pre-treatment scores. A composite outcome score (COS) incorporating TUG/MOCA/NBSS was computed.

Results Eleven patients (4 female; mean age 74.8+/-4.2 years) underwent successful eShunt placement. Follow-up data showed significant improvement in gait by 35.4% at 30-days (n=6, P<0.003), 24.8% at 90-days (n=6, p<0.03) and by 32.8% at 180-days (n=4, p<0.01) compared to baseline. MOCA and NBSS showed significant improvements at 30-days and the COS was significantly improved at all time points (p<0.005 at 30-, 90- and 180-days). No procedural/delayed hemorrhage or unexpected readmissions were encountered during this early follow-up phase.

Conclusion In elderly patients affected by NPH and its insidious effect on mobility, cognition and urinary continence, these results show that the endovascular eShunt implant can be safely deployed with a favorable risk profile and with rapid and sustained improvements in functional outcome scores.

Disclosure of Interest A. Malek and C. Heilman are co-founders, shareholders, investors and consultants

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.