Occlusion of the Ascenda Catheter in a Patient with Pump Twiddler’s Sydrome: A Case Report

Shao, Jianning; Frizon, Leonardo A.; Machado, André G.; McKee, Keith E.; Béthoux, François; Hartman, J. Ted; Nagel, Sean J.

doi:10.5812/aapm.65312

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…One commonly cited reason for pump flipping across adult and pediatric populations is the creation of an oversized pocket. 12,13 Generally, it is recommended that the pump pocket be fashioned only minimally larger than the pump to prevent excessive movement. 14 In addition, several techniques can facilitate pump anchoring within the pocket.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Intrathecal Drug Pump Flipping Using Fascial Flaps: A Technical Description and Case Series

Taghlabi,

Bhenderu,

Guerrero

et al. 2023

Operative Neurosurgery

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BACKGROUND AND OBJECTIVES: Intrathecal drug therapy is a common treatment for dystonia, pain, and spasticity using implanted pump and catheter systems. Standardized management of intrathecal drug pump (ITDP) migration and flipping has not been well established in the literature. This study reports the use of soft tissue to address less common pump complications such as pump flipping, migration, and difficulty in medication refill. METHODS: A retrospective chart review of intrathecal pump cases performed by two surgeons between February 2020 and August 2022 was conducted. Patients with complications such as pump flipping, migration, or challenges in medication refill treated with soft tissue flaps were included. Patient demographics, comorbidities, and perioperative data were collected. RESULTS: A total of five patients with ITDP complicated by pump flipping, migration, malposition, or difficulty in medication refill that were treated using fascial flaps were included in the study. Three technical considerations when revising ITDP complications are secure pump anchoring, reliable wound closure, and ease of pump medication refill. Cases 1 and 2 demonstrate the technique of secure pump anchoring with a rectus fascial flap. Cases 3 and 4 show a technique to achieve reliable vascularized wound closure, and case 5 describes a technique to solve an uncommon problem of a thick subcutaneous abdominal tissue preventing the refill of the ITDP medication. CONCLUSION: Soft tissue flaps may serve as a treatment option for patients with uncommon ITDP complications. De-epithelialized dermal fasciocutaneous or fascial flaps may be developed to anchor the pump more securely. Cross-discipline collaboration may further delineate the technique, benefits, and outcomes of this approach.

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Section: Discussionmentioning

confidence: 99%

Treatment of Intrathecal Drug Pump Flipping Using Fascial Flaps: A Technical Description and Case Series

Taghlabi,

Bhenderu,

Guerrero

et al. 2023

Operative Neurosurgery

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“…(ii) Medical Specialties -Healthcare Technologies Pacemakers were the most common implanted medical technology described in the literature, with complications including: runaway pacemakers (46)); pacemaker electrical storms (47); Reel's syndrome, Twiddler's syndrome and Ratchet Syndrome -all referring to complications arising from the displacement of wire based systems (48,49). Now that pacemaker technology has been extended to other domains, such as Deep Brain Stimulators (DBS) in neurology and gastric stimulators in gastroenterology (50), previously reported pacemaker complications are manifesting in the context of these new devices e.g the neurological patient with an intrathecal baclofen pump who presented with withdrawal as a result of Twiddler's Syndrome (51).…”

Section: Medical Specialtiesmentioning

confidence: 99%

21st century medicine and emerging biotechnological syndromes: a cross- disciplinary systematic review of novel patient presentations in the age of technology

Straw

Rees

Nachev

2023

Preprint

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Background Biotechnological syndromes refer to the illnesses that arise at the intersection of human physiology and digital technology. Now that we experience health and illness through so much technology (e.g. wearables, telemedicine, implanted devices), the medium is redefining our expression of symptoms, the observable signs of pathology and the range of diseases that may occur. Here, we systematically review all case reports describing illnesses related to digital technology in the past ten years, in order to identify novel biotechnological syndromes, map out new causal pathways of disease, and identify gaps in care that have disadvantaged a community of patients suffering from these digital complaints. Methods PubMed, MEDLINE, Scopus, Cochrane Library and Web of Science were searched for case reports and case series that described patient cases involving biotechnological syndromes from 01/01/2012 to 01/02/2022. For inclusion the technology had to play a causative role in the disease process and had to be digital (as opposed to simple electronic). Results Our search returned 7742 articles, 1373 duplicates were removed, 671 met the criteria for full review and 372 were included in the results. Results were categorised by specialty, demonstrating that syndromes were most common in Cardiology (n = 162), Microbiology and Infectious Diseases (n = 36), and Emergency and Trauma (n = 26). Discussion The 372 unique patient cases demonstrated a range of severity from mild (e.g., injuries related to Pokemon Go) to moderate (e.g. pacemaker-generated rib fractures) and severe (e.g. ventilator software bugs causing cardiac arrest). Syndromes resulted from both consumer technology (e.g. gaming addictions) and medical technologies (e.g. errors in spinal stimulators). Cases occurred at both the individual level (e.g. faulty insulin pumps) and at the population level (e.g. harm from healthcare cyberattacks). Limitations This was a retrospective systematic review of heterogeneous reports which may only reflect a small proportion of true prevalence rates in the population.

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“…Now that pacemaker technology has been extended to other domains, such as Deep Brain Stimulators (DBS) in neurology and gastric stimulators in gastroenterology [52], previously reported pacemaker complications are manifesting in the context of these new devices e.g. the neurological patient with an intrathecal baclofen pump who presented with withdrawal as a result of Twiddler's Syndrome [53].…”

Section: Medical Specialties -Healthcare Technologiesmentioning

confidence: 99%

21st century medicine and emerging biotechnological syndromes: a cross-disciplinary systematic review of novel patient presentations in the age of technology

Straw,

Rees,

Nachev

2023

BMC Digit Health

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Background Biotechnological syndromes refer to the illnesses that arise at the intersection of human physiology and digital technology. Now that we experience health and illness through so much technology (e.g. wearables, telemedicine, implanted devices), the medium is redefining our expression of symptoms, the observable signs of pathology and the range of diseases that may occur. Here, we systematically review all case reports describing illnesses related to digital technology in the past ten years, in order to identify novel biotechnological syndromes, map out new causal pathways of disease, and identify gaps in care that have disadvantaged a community of patients suffering from these digital complaints. Methods PubMed, MEDLINE, Scopus, Cochrane Library and Web of Science were searched for case reports and case series that described patient cases involving biotechnological syndromes from 01/01/2012 to 01/02/2022. For inclusion the technology had to play a causative role in the disease process and had to be digital (as opposed to simple electronic). Results Our search returned 7742 articles, 1373 duplicates were removed, 671 met the criteria for full review and 372 were included in the results. Results were categorised by specialty, demonstrating that syndromes were most common in Cardiology (n = 162), Microbiology and Infectious Diseases (n = 36), and Emergency and Trauma (n = 26). Discussion The 372 unique patient cases demonstrated a range of severity from mild (e.g., injuries related to Pokemon Go) to moderate (e.g. pacemaker-generated rib fractures) and severe (e.g. ventilator software bugs causing cardiac arrest). Syndromes resulted from both consumer technology (e.g. gaming addictions) and medical technologies (e.g. errors in spinal stimulators). Cases occurred at both the individual level (e.g. faulty insulin pumps) and at the population level (e.g. harm from healthcare cyberattacks). Limitations This was a retrospective systematic review of heterogeneous reports, written in English, which may only reflect a small proportion of true prevalence rates in the population.

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Occlusion of the Ascenda Catheter in a Patient with Pump Twiddler’s Sydrome: A Case Report

Cited by 7 publications

References 14 publications

Treatment of Intrathecal Drug Pump Flipping Using Fascial Flaps: A Technical Description and Case Series

Treatment of Intrathecal Drug Pump Flipping Using Fascial Flaps: A Technical Description and Case Series

21st century medicine and emerging biotechnological syndromes: a cross- disciplinary systematic review of novel patient presentations in the age of technology

21st century medicine and emerging biotechnological syndromes: a cross-disciplinary systematic review of novel patient presentations in the age of technology

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