Flow ventricular catheters for shunted hydrocephalus: initial clinical results

Galarza, Marcelo; Etüş, Volkan; Sosa, Fidel; Argañaraz, Romina; Mantese, Beatriz; Gazzeri, Roberto; Montoya, Christian Garcia; Rosa, Pedro de la; Guerrero, Antonio López; Chaban, Gerald; Giménez, Ángel; Amigó, José M.

doi:10.1007/s00381-020-04941-8

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…Recent developments of parametric designs for proximal shunt catheters have shown to produce more homogenous flow patterns [1,2] in order to reduce occlusion and extend shunt survival. These new catheter designs are paired with a valve mechanism for flow control.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the regulating mechanism in CSF diversion is usually provided by an in-line differential pressure valve with or without programmable features and anti-siphon devices. Despite all the innovations with valve mechanisms and anti-siphon devices, failure rate remains quite high [1], and in the face of the "scaled" design's lack of an "on-off" phenomenon, we still see benefit in characterizing the highresistance proximal design.…”

Section: Discussionmentioning

confidence: 99%

“…4) in comparison with standard control catheters with varying numbers of inlet holes. In a standard catheter, the number of inlet holes did not affect flow rates (1)(2)(3)(4)(5)(6)(7)(8). The open-ended catheter without side inlets exhibited the high-est flow rate (9).…”

Section: Discussionmentioning

confidence: 99%

“…Typical proximal catheters consist of rows of circular inlets adding negligible resistance to the system. The number, size, and patterns of holes have been altered in studies attempting to create better designs [1][2][3][4][5][6][7]; however, manipulations of inlet shape have been lacking. The focus of this study was to assess the feasibility of a variety of intraventricular catheter inlet designs in regulating CSF flow independent of a pressure valve.…”

Section: Introductionmentioning

confidence: 99%

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High-resistance proximal “scaled” ventricular catheters

Olson

Ivankovic

et al. 2021

Childs Nerv Syst

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Purpose Prove the concept of high-resistance proximal catheters for valve-independent treatment of hydrocephalus. Methods A preliminary design process yielded optimal high-resistance proximal ventricular catheters with a "scaled" design and parallel-oriented, U-shaped inlets. Prototypes were manually constructed using carving tools to stamp through silicone tubings. A testing apparatus was developed to simulate cerebrospinal fluid flow through a catheter, and the prototypes were tested against a control catheter for exhibition of an "on/off" phenomenon whereby no flow occurs at low pressures, and flow begins beyond a pressure threshold. Flow distribution was visualized with India ink. Regression analysis was performed to determine linearity. ResultsThe new designs showed varying amounts of improved flow control with the "scaled" design showing the most practical flow rate control across various pressures, compared to the standard catheter; however, no true "on/off" phenomenon was observed. The "scaled" design showed various degrees of dynamism; its flow rate can be time dependent, and certain maneuvers such as flushing and bending increased flow rate temporarily. Variation in the number of inlets within each "scaled" prototype also affected flow rate. Contrastingly, the flow rate of standard catheters was found to be independent of the number of inlet holes. Ink flow showed even flow distribution in "scaled" prototypes. Conclusions This initial feasibility study showed that high-resistance ventricular catheters can be designed to mimic the current/valved system. The "scaled" design demonstrated the best flow control, and its unique features were characterized.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%