Could hydrocephalus shunts have a role in the treatment of lymphoedema?

Jemima Bell, Neil Piller

Research output: Contribution to journalArticlepeer-review

Abstract

Lymphoedema is a consequence of impaired lymphatic drainage. Available treatment options vary in efficacy and impact on the individual. Whilst all are useful in reducing the extent and impact of lymphoedema, there are confounding factors such as patient compliance, financial and physical costs and unpredictably variable outcomes. There seems to be no single treatment that is affordable, effective and sustainable for patients with lymphoedema. This review introduces the novel idea of a modified hydrocephalus shunt as a surgical alternative to treat (and perhaps prevent) lymphoedema. Hydrocephalus shunts allow cerebrospinal fluid (CSF) to circumvent an obstruction during periods of impaired absorption, removing the build-up of fluid that causes hydrocephalus, working on a low pressure system. Lymphatic pumping pressures in failing arm lymphatics have been recorded as approximately 25 mmHg¹. In early stage leg lymphoedema, pressures have been recorded around 70mmHg (diastolic) and 100mmHg (systolic), whilst late stage lymphoedema has been recorded as 20mmHg, though often these lymphatics are very difficult to cannulate. As hydrocephalus shunts work on pressures as low as 15-25mmHg at flow rates as low as 5ml/hr it is plausible that they could be used to facilitate normal flow, but importantly prevent retrograde flow of lymph in failing or failed lymphatics, thereby reducing lymphoedema.
Original languageEnglish
Pages (from-to)70-74
Number of pages5
JournalWound Practice and Research
Volume24
Issue number2
Publication statusPublished - Jun 2016

Keywords

  • Lymphoedema
  • hydrocephalus
  • shunt
  • intralymphatic pressure

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