Therapy of shunt insufficiency

Over the recent years several methods to manage shunt insufficiency were published. Some of the are effective and explained here. 

Advantages and disadvantages of the various treatment options for shunt insufficiency

  Spacer treatment Injection technique filler / growth factor Suture techniques Custom-fit prosthesis Surgical shunt closure
For a dilated atropic shunt no yes yes yes yes
For an infected necrotic shunt yes no no yes no
Risks aspiration allergies to fillers, infection of fillers, granulomas etc. infection low risks of surgery
Success rate moderate short-term – high, long-term – low moderate high high
In-patient / out-patient in-patient out-patient out-patient out-patient in-patient
Patient comfort low high moderate high low
Costs very high high low, under general anesthesia high high very high