David Qi1, Anup Patel2, Robert Dunwoody2, Shannon McCall2, Sarah Bach2, Julian Lin2. 1. Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL, USA. mq3@uic.edu. 2. Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
Abstract
PURPOSE: Proximal ventricular shunt catheter occlusion remains a problematic cause of shunt malfunction, and there is no consistent in vivo or in vitro model to help clinicians and researchers study this phenomenon. METHODS: An in vitro model utilizing standard proximal ventricular catheter and biological occluding agents mimicking choroid plexus was designed, constructed, and calibrated to occlude consistently within a specified timeframe. Hydrostatic pressure differential of 100 cmH2O was used as a driving force to generate flow through the catheter. Chalaza and vitelline membranes were harvested from avian eggs and used as occluding agents. Successful occlusion was defined as a greater than 90% reduction in volumetric flow rate through distal outlet. Histological sections of occluded catheters were performed and interpreted by a neuropathologist. RESULTS: Initial trials demonstrated successful standard catheter occlusion within 24 h using chalaza, vitelline membrane, and combination treatments. Repeat trials demonstrated consistency in successful occlusion within 5 min utilizing only vitelline membrane treatment. Histopathology demonstrated the vitelline membrane to consist of a thin, superficial layer of extraembryonic ectoderm; the chalaza was observed to consist of strands of mucin protein. CONCLUSIONS: An in vitro model of proximal ventricular shunt catheter occlusion was developed and calibrated for successful occlusion within 5 min. Future studies may utilize this model to rapidly test occlusion-resistant shunt designs and de-obstruction techniques.
PURPOSE: Proximal ventricular shunt catheter occlusion remains a problematic cause of shunt malfunction, and there is no consistent in vivo or in vitro model to help clinicians and researchers study this phenomenon. METHODS: An in vitro model utilizing standard proximal ventricular catheter and biological occluding agents mimicking choroid plexus was designed, constructed, and calibrated to occlude consistently within a specified timeframe. Hydrostatic pressure differential of 100 cmH2O was used as a driving force to generate flow through the catheter. Chalaza and vitelline membranes were harvested from avian eggs and used as occluding agents. Successful occlusion was defined as a greater than 90% reduction in volumetric flow rate through distal outlet. Histological sections of occluded catheters were performed and interpreted by a neuropathologist. RESULTS: Initial trials demonstrated successful standard catheter occlusion within 24 h using chalaza, vitelline membrane, and combination treatments. Repeat trials demonstrated consistency in successful occlusion within 5 min utilizing only vitelline membrane treatment. Histopathology demonstrated the vitelline membrane to consist of a thin, superficial layer of extraembryonic ectoderm; the chalaza was observed to consist of strands of mucin protein. CONCLUSIONS: An in vitro model of proximal ventricular shunt catheter occlusion was developed and calibrated for successful occlusion within 5 min. Future studies may utilize this model to rapidly test occlusion-resistant shunt designs and de-obstruction techniques.
Authors: Marcelo Galarza; Ángel Giménez; José Valero; Olga Porcar Pellicer; José María Amigó Journal: Childs Nerv Syst Date: 2013-07-24 Impact factor: 1.475
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