3 Pressure vs 5 Pressure Depus Adjustable Shunt Systems

How 3 Pressure and 5 Pressure Depus adjustable shunt systems differ: pressure levels, the matching Adjustment Kit and what to confirm before ordering.

The difference between 3 Pressure and 5 Pressure Depus adjustable systems is the number of settings the valve offers after implantation: three levels (low, medium and high) or five. Both belong to the polysulfone Depus family of shunt systems, both are adjusted non-invasively, and each one uses its own version of the Depus Adjustment Kit.

Key takeaways

• The two systems differ by the number of pressure levels: three (low, medium, high) or five.
• Each system has its own Adjustment Kit: DP-ADJKIT3 or DP-ADJKIT5, with the same three tools.
• A level count does not show the range or spacing of pressures, so check the values in the IFU for the exact valve.
• State 3 Pressure or 5 Pressure in words on the order and in the implant record.

The choice of valve and setting belongs to the surgeon and the instructions for use (IFU).

What are the 3 Pressure and 5 Pressure Depus systems?

An adjustable Depus shunt is a ventriculoperitoneal (VP) system built around a polysulfone valve from the same family as the fixed-pressure Depus, which uses a ruby ball and titanium spring mechanism. On a fixed-pressure Depus, the low, medium or high category is chosen when the valve is ordered. On an adjustable Depus, the pressure level can be checked and changed after implantation with the Adjustment Kit.

“3 Pressure” and “5 Pressure” name how many levels the adjustable system has. For a wider view of when a team considers an adjustable valve at all, see our guide to fixed-pressure and adjustable shunt valves.

How do the two systems compare?

The difference comes down to the number of levels and the kit that goes with them. The kit’s tools and presentation are the same in both.

What does a higher level count tell you?

Five levels means five positions to choose between after implantation, against three. The count alone does not show the overall range or the size of the steps, and “low” on a 3 Pressure valve should not be assumed to match the lowest of the five levels, or “low” on a fixed-pressure Depus.

If a protocol or tender depends on a specific value, ask our product specialists for the figures in writing and check them against the IFU for the exact valve.

What is the same in both systems?

Both systems follow one adjustment sequence, using the same three tools:

• Locate: the locator identifies the valve position and the target directions of the pressure levels.
• Check: the compass shows the current pressure level.
• Choose: the target level is selected according to the adjustable system in use.
• Set: the magnet brings the valve to the target level.
• Confirm: the level is checked again to verify that the valve is at the target setting.

This is an outline, not a procedure. The steps in clinical use come from the IFU, and our article on adjustable shunt technology gives more background.

The kit options also apply to adjustable Depus as a whole: paediatric and adult valves, standard or antibiotic-impregnated catheters, an optional antisiphon device, and four silicone reservoir alternatives (adult or paediatric, flat-bottom or burr-hole). Check availability for the version you want on the quotation.

Why does the Adjustment Kit version matter?

The Depus Adjustment Kit comes in two versions, one for each system: the 3 Pressure kit sets the valve to low, medium or high, and the 5 Pressure kit sets and checks systems that have five levels. A department that follows patients on both systems therefore needs both kits, and staff need to know which is which.

The kit is not an implant or a consumable. It is non-sterile, reusable and kept in its own case, so plan where it lives. It needs to be available wherever a valve will be checked or set, which may not be the place where the shunt was implanted.

What should be confirmed on the order and in the record?

The adjustable valve codes (DP-A for paediatric and DPA-A for adult, with their kit variants) do not themselves show 3 or 5. Write the version out in words on the order and check it on the quotation. A complete order line covers:

• Patient group: paediatric or adult valve.
• Pressure version: 3 Pressure or 5 Pressure.
• Configuration: valve alone or VP kit, standard or antibiotic-impregnated valve body and catheters, with or without antisiphon device.
• Reservoir: which of the four alternatives is wanted.
• Adjustment Kit: DP-ADJKIT3 or DP-ADJKIT5, unless the department already holds the right one.

The same details belong in the implant record, with the current setting. Whoever sees the patient next needs to know which system was implanted before picking up a kit.

How can a department approach the choice?

We do not link either version to an indication or a patient group. The questions below help a surgeon and a purchasing team reach a decision together:

• How many distinct levels does the surgeon expect to use in follow-up?
• Do the numeric values for each version, once supplied, suit the surgeon’s practice?
• Does the department already hold one kit version, with staff trained on it?
• Would running both versions add a risk of picking up the wrong kit, and is that worth it?

Talk to a DESU product specialist

For pressure values, product codes or availability of 3 Pressure and 5 Pressure adjustable Depus systems, write to sales@desu.tr, use the contact page or request a quote.

Frequently asked questions

Can a 3 Pressure Adjustment Kit be used on a 5 Pressure valve?

The two kits are separate versions, one for each system. Use the kit that matches the implanted valve, and follow the IFU.

Is the Depus Adjustment Kit single-use?

No. It is a reusable accessory, supplied non-sterile in a dedicated reusable case, in both the 3 Pressure and the 5 Pressure version.

Is an adjustable Depus valve metal-free?

Metal-free describes our silicone Defit and Decurve valves, not Depus, whose family mechanism uses a titanium spring. Check the IFU before any MRI.

Can adjustable Depus be supplied as an LP kit?

Adjustable Depus is a ventriculoperitoneal system, and the Depus LP kit codes cover low, medium and high pressure valves. If a lumboperitoneal adjustable configuration is of interest, talk to our product specialists.

Related standards

• ISO 13485: Medical devices — Quality management systems
• ISO 7197: Neurosurgical implants — Sterile, single-use hydrocephalus shunts and components