Adjustable gravitational valve for the treatment of hydrocephalus

The MIETHKE proSA® Shunt System represents the first generation of adjustable gravitational valves that allow postoperative adaptation to the individual needs of the patient for the upright body position. [1,2]

It offers effective protection against overdrainage through an individually and continuously adjustable large opening pressure range of 0-40 cmH2O [3,4]

The patented verification and adjustment instruments enable a simple, quick and uncomplicated adjustment of the pressure level without having to perform X-rays that are stressful for the patient. [3,4,5,6]


  • MRI-compatible up to 3 Tesla​
  • Efficient protection against over-drainage through individual and infinitely variable adjustable opening pressure from 0-40 cmH2O ​
  • No X-ray control after MRI necessary​


The MIETHKE proSA® is available as a single valve or as a shunt system with different components.


  • Treatment of Hydrocephalus

[1] 2016, Miyake H.: "Shunt Devices for the Treatment of Adult Hydrocephalus: Recent Progress and Characteristics", Neurol Med Chir (Tokyo) 56(5): 274-283,

[2] 2012, Czosnyka M., Czosnyka Z. and Pickard J. D.: "Programmable Shunt Assistant tested in Cambridge shunt evaluation laboratory", Acta Neurochir Suppl 113: 71-76,

[3] 2013, Lemcke J., Meier U., Muller C., Fritsch M. J., Kehler U., Langer N., Kiefer M., Eymann R., Schuhmann M. U., Speil A., Weber F., Remenez V., Rohde V., Ludwig H. C. and Stengel D.: "Safety and efficacy of gravitational shunt valves in patients with idiopathic normal pressure hydrocephalus: a pragmatic, randomised, open label, multicentre trial (SVASONA)", 

J Neurol Neurosurg Psychiatry 84(8): 850-857,

[4] 2014, Tschan C. A., Antes S., Huthmann A., Vulcu S., Oertel J. and Wagner W.:

"Overcoming CSF overdrainage with the adjustable gravitational valve proSA", 

Acta Neurochir (Wien) 156(4): 767-776,

[5] 2019, Mirone G., Spina D. and Sainte-Rose C.: "Shunt hardware",  Pediatric Hydrocephalus 2, Editor: G. Cinalli

[6] 2020, Czosnyka Z.: "Comparison of adjustable valves-is there a model 'optimal' for management of pediatric hydrocephalus?",  Child's Nervous System 36: 2143-2144, "All valves are comfortable in programming"