Abstract
Proximal obstruction due to cellular material is a major cause of shunt failure in hydrocephalus management. The standard approach to treat such cases involves surgical intervention which unfortunately is accompanied by inherent surgical risks and a likelihood of future malfunction. We report a prototype design of a proximal ventricular catheter capable of noninvasively clearing cellular obstruction.Methods: In-vitro cell-culture methods show that low-intensity ac signals successfully destroy a cellular layer in a localized manner by means of Joule heating induced hyperthermia. A detailed electrochemical model for determining the temperature distribution and ionic current density for an implanted ventricular catheter supports our experimental observations. In-vitro experiments with cells cultured in a plate as well as cells seeded in mock ventricular catheters demonstrated that localized heating between 43°C and 48°C caused cell death. This temperature range is consistent with hyperthermia. The electrochemical model verified that Joule heating due to ionic motion is the primary contributor to heat generation. Hyperthermia induced by Joule heating can clear cellular material in a localized manner. This approach is feasible to design a noninvasive self-clearing ventricular catheter system. A shunt system capable of clearing cellular obstruction could significantly reduce the need for future surgical interventions, lower the cost of disease management, and improve the quality of life for patients suffering from hydrocephalus.
Highlights
IN SPITE OF the various complications that plague chronically implanted ventricular catheters [1],[2] ventricular CSF shunting remains the primary approach for hydrocephalus management [3]
To address the pressing need for non-invasive clearance of catheter obstruction, we propose a design for a self-clearing ventricular catheter which induces hyperthermia by localized Joule heating that disintegrates obstructing cellular material and debris, and restores catheter patency
These results show that low-voltage Joule heating to remove cellular obstruction in a proximal ventricular catheter and reestablish CSF flow is feasible
Summary
IN SPITE OF the various complications that plague chronically implanted ventricular catheters [1],[2] ventricular CSF shunting remains the primary approach for hydrocephalus management [3]. Shunt failure incidence after 1 year has been reported to be as high as 40 – 50% [4],[5] and long term studies show that multiple shunt revisions per patient are common [5]–[7]. A patient who experiences shunt failure is more likely to require repeated shunt revisions in the future [8],[9]. Schematically represented, is a Partial support through an Innovator Award Koschnitzky) and NSF Grant # 1706921 is gratefully acknowledged
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
