ShuntCheck is an aid to the detection of flow in implanted cerebrospinal fluid (CSF) shunts. ShuntCheck includes Micro-Pumper, a component which may be used to temporarily increase CSF flow in suspected non-flowing, patent shunts during the ShuntCheck test. ShuntCheck cannot alone diagnose CSF shunt function or malfunction. The clinical diagnosis of CSF shunt function or malfunction, incorporating the flow information from ShuntCheck, should be made only by a qualified neurosurgeon.

1. The ShuntCheck Thermosensor is
placed over shunt where the catheter
crosses the clavicle
CSF inside the shunt catheter is cooled for
60 seconds with an instant ice pack placed
.
ShuntCheck Overview
Note: For Indications for Use and detail information concerning the ShuntCheck III product and
procedure, please refer to the ShuntCheck Operating Manual
ShuntCheck uses non-invasive thermal dilution to detect fluid flow in CSF shunts.
The
sensor monitors the skin temperature for 6 minutes after the ice is removed
Sensor data is analyzed by the ShuntCheck software and test results are displayed on a laptop
or tablet computer.
The results screen below illustrates what the results may look like for a flowing shunt.
The panel on the left summarizes patient and test information including the test result of Flow
Confirmed. The panel on the left presents a time-temperature graph of sensor data. (The blue
bar shows the 60 second ice pack placement period). This test shows a 0.44°C temperature
drop due to chilled CSF flowing beneath the sensor.

2.
Photo of Micro-Pumper (left) and Micro-Pumper is use (right)
The results screen below illustrates what the results may look like for a non-flowing shunt.
Since the shunt is not flowing, cooled CSF has not reached the sensor and the time-
temperature graph shows no temperature decrease. This test summary is Flow Not Confirmed.
Micro-Pumper Overview
Patent shunts may not flow continuously. Micro-Pumper is a handheld device which is held
against and vibrates the shunt valve for 60 seconds to generate a temporary increase in CSF
flow in patent but temporarily non-flowing shunts.
ShuntCheck Testing Including Micro-Pumper
When Micro-Pumping is included in the ShuntCheck test procedure, the CSF in the shunt is
cooled two times with the instant ice pack. When review the graphical results, the first
application provides an assessment
immediately followed by the Micro-Pumper procedure and provides an assessment of Micro-
Pumper-generated flow.

3. The results screen below illustrates what the results may look like for a naturally flowingshunt
with increased flow due to Micro-Pumping.
The two blue bars depict the timing for the two ice applications and the green bar depicts the
timing for the Micro-Pumper application. Natural CSF flow has generated a 0.22°C temperature
decrease in the first part of the test. Micro-Pumper-generated flow further decreases
temperature.
The next results screen illustrates what the results may look like for a non-flowing shunt. The
temperature remains largely unchanged throughout the test.

4. The final results screen illustrates what the results may look like for a temporarily non-flowing
shunt and the impact of a temporary increase in flow due to Micro-Pumping.
The ShuntCheck III System
The ShuntCheck III system consists of four components the ShuntCheck Thermosensor
(which monitors skin temperature), the Data Acquisition Unit (DAQ which converts the sensor
signal into digital format), a Windows 7 tablet or laptop computer running ShuntCheck software
and Micro-Pumper (the handheld device which generates a temporary increase in CSF flow in
patent shunts). The Thermosensor Test Pack also includes an Instant Ice Pack plus a skin
marker pen, so that all the items required for the test are included in a clamshell pack.
The full system is shown below
Counterclockwise from top left: the Thermosensor Pack clamshell, the skin
marker pen, the instant ice pack, the thermosensor, the DAQ and a
Windows 7 tablet computer running ShuntCheck software.