Selecting The Appropriate Shunt System; Possible Shunt Components - MIETHKE miniNAV Mode D'emploi

GB | INSTRUCTIONS FOR USE
SELECTING THE APPROPRIATE SHUNT
SYSTEM
The miniNAV is available in four different pres-
sure levels: 0, 5, 10 and 15 cmH
pressure setting should be chosen according
to the clinical picture (normal-pressure hydro-
cephalus, hypertonic hydrocephalus).
In case the patient suffers from symp-
toms associated with overdrainage, or com-
plications with overdrainage are expected,
we recommend the implantation of the
SHUNTASSISTANT in addition to the mini-
NAV. The SHUNTASSISTANT is a hydrostatic,
supplementary valve specially designed for
preventing problems with overdrainage. It is
made by Christoph Miethke GmbH & Co. KG.
The coding of the miniNAV can be identified
according to the shape of the valve's hous-
ing. For example the miniNAV with an open-
ing pressure of 5 cmH
imal part (curved inwards) and a convex distal
part (curved outwards) (fig. 4). Each miniNAV
is calibrated in accordance with strict quality
control standards. The following pressure lev-
els are available:
pressure Coding
rating
(cmH O)
2
0
5
10
15
12
O. The
2
O has a concave prox-
2
Fig. 4: X-ray image of the miniNAV (pressure rating
5 cmH 2 O)
a. concave
b. convex

POSSIBLE SHUNT COMPONENTS

The miniNAV is available with different shunt
accessories. These variations are comprised
of a variety of components, which are intro-
duced briefly below:
The Burrhole Reservoir is positioned in the
cranial burr hole. It allows for measurement
of the intraventricular pressure, injection of
drugs and extraction of CSF. Its solid titanium
base is highly puncture-resistant. All reser-
voirs are available with integrated catheters
or connectors. A special Burrhole Reservoir is
the SPRUNG RESERVOIR. An additional new
feature of this reservoir is that CSF can be
flushed towards the miniNAV because of a
non-return valve in the bottom of the reser-
voir. By this mechanism, flow in the direction
of the ventricular catheter is avoided during
the pumping procedure. The opening pres-
sure of the shunt system is not increased by
the implantation of the SPRUNG RESERVOIR.
The Prechamber is positioned on the cranium.
It allows for measurement of the intraventric-
ular pressure, injection of drugs, extraction
of CSF and palpatory ventricle inspection. Its
solid titanium base is highly puncture-resis-
tant. A puncture of the Prechamber or the
CONTROL RESERVOIR should be performed
as perpendicular to the reservoir surface as
possible with a cannula of maximum diameter
of 0.9 mm. 30 punctures are possible without
any restrictions. A special Prechamber is the
CONTROL RESERVOIR. As an additional new
feature of this reservoir, CSF can be flushed
towards the miniNAV because of a non-return
miniNAV