Clinical Experience with the Denver Shunt: A New Silicone-Rubber Shunting Device for the Treatment of Hydrocephalus

ISSATISFACTION with currently marketed devices for the treatment of hydrocephalus has provided the impetus for the development of a new shunting system. Problems attendant to shunt placement are many, 2,3,s,1~ consisting primarily of: 1 ) erratic performance or blocking of the device in vivo, especially in the presence of particulate contamination or unusually elevated protein levels of the cerebrospinal fluid; 2) a significant incidence of infectious complications, conceivably related to nonautoclavable devices with metallic components or plastic devices with complex recessing; 5,9 and 3) the appreciable expense of the shunting device itself. The latter factor limits the availability of the operative procedure to a restricted population of patients within a favored social setting. Our objective has been to develop an inexpensive device of simple yet rugged construction, devoid of metallic parts, capable of passing fluid of high viscosity or particulate contamination without obstruction. This report deals with a description of a new shunting system, 'the Denver shunt* designed to meet these specifications, and our initial surgical experiences with this device in 57 patients at the University of Colorado Medical Center over an 18-month period. Description and Flow Characteristics The bodies of the Denver shunt are molded and vulcanized in one piece from Silastic.t The proximal valve of the shunt is a simple slit contained within the molded part and analogous to a venous valve. The distal