Evidence that prior endoscopic third ventriculostomy with choroid plexus cauterization protects against…

Cohort studyJournal of neurosurgery. Pediatrics· Jul 2026

Evidence that prior endoscopic third ventriculostomy with choroid plexus cauterization protects against subsequent shunt failure among infants treated for hydrocephalus.

Benjamin C Warf, Emma N Puglisi, Dylan S Keusch … Scellig S D Stone

Pediatric NeurosurgeryCohort studyTreatmentQ1IF 2.0

Prior endoscopic third ventriculostomy with choroid plexus cauterization was linked to higher 2-year shunt survival.

Evidence that prior endoscopic third ventriculostomy with choroid plexus cauterization protects against subsequent shunt failure among infants treated for hydrocephalus.

Benjamin C Warf … Scellig S D Stone

Journal of neurosurgery · Jul 2026 · Q1 in Surgery

Background

It is unclear whether shunt survival differs for infants in whom prior endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) failed compared with those treated initially by shunt placement.

Purpose

The aim of this study was to determine whether prior ETV/CPC positively impacts shunt survival among infants with hydrocephalus regardless of etiology.

Methods

The authors conducted a historical cohort review of all patients under 12 months corrected age who underwent ventriculoperitoneal shunt (ventriculoperitoneal shunt) placement either with or without prior ETV/CPC at their institution between December 2008 and December 2023.

n = 122 infants

Results

shunt lasted 2 years in most infants with prior ETV/CPC, much better odds

OR 2.40 (95% CI 1.10 to 5.10)

CI excludes the null - significant

More results

The study included 122 infants with and 46 infants without prior ETV/CPC who underwent ventriculoperitoneal shunt placement.

The median pre-shunt frontal-occipital horn ratios was greater in the ETV/CPC group.

More results

Seventy-one infants (58%) with prior ETV/CPC remained free of shunt revision compared with 17 infants (37%) with primary shunt placement (OR 2.4, 95% CI 1.1-5.1; p = 0.01).

The estimated 5-year survival was 60% with and 45% without prior ETV/CPC (p = 0.045).

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Conclusion · 1 of 2

Infants who underwent ETV/CPC prior to ventriculoperitoneal shunt placement had better shunt survival than those who did not.

Conclusion · 2 of 2

ETV/CPC might reduce the risk of subsequent shunt failure, indicating the potential benefit of the procedure even when it fails.

Evidence that prior endoscopic third ventriculostomy with choroid plexus cauterization protects against subsequent shunt failure among infants treated for hydrocephalus.

Evidence that prior endoscopic third ventriculostomy with choroid plexus cauterization protects against subsequent shunt failure among infants treated for hydrocephalus.

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