Image: The new ventricular catheter and flusher system is designed to restore CSF flow (Photo courtesy of Anuncia).
A non-invasive retrograde flushing system helps clinicians restore or increase cerebrospinal fluid (CSF) flow in a blocked ventricular catheter shunt.
The Anuncia (Lowell, MA, USA) Alivio System is designed to provide a non-invasive option for neurosurgeons to restore CSF flow in a non-flowing shunt, which may potentially avert emergency revision surgery. The system, which can be used in conjunction with any CSF shunt flow-regulating valve and drainage catheter, is comprised of a flusher and a ventricular catheter (VC) with a unique relief membrane that restores or increase CSF flow in a and unblocks occluded inlet holes.
The flusher component does not regulate CSF flow in the implanted shunt system; instead, it allows fluid from the ventricular catheter to flows freely, without restriction through a passive flow channel. During flushing, the passive channel is manually occluded to create temporary one-way flow into the VC. After a controlled and limited fluid pulse is sent from the flusher, the flush dome refills with CSF from the VC and resumes free flowing fluid through the passive flow channel.
In the case of completely obstructed flow through the shunt, retrograde flushing of the VC is performed by depression of the flush dome, which sends a controlled and limited pulse of fluid--either native CSF or sterile saline introduced during a priming procedure before implant--into the VC. In a life-threatening case of a severely occluded catheter, the relief membrane of the VC opens to restore antigrade flow in the shunt system.
“If you have a shunt, you are always worried about what might happen in the future. Close to half of shunts will have a revision within the first year of implantation. About 80% will require a revision within 10 years,” said neurosurgeon Joseph Madsen, MD, co-inventor of the Alivio system. “I am delighted that my fellow neurosurgeons will have an option to intervene non-invasively when treating hydrocephalus patients who come in with complications related to ventricular shunt obstruction.”
Hydrocephalus is a condition in which an excess of CSF accumulates within the ventricles and increases pressure in the brain. But even as implanted CSF shunts help relieve the pressure build-up, according to the Hydrocephalus Association (Bethesda, MD, USA), at least 50% of patients suffer from shunt failures and blockages within two years, requiring repeated revision surgeries. The costs of these often-emergent, revision surgeries to restore CSF flow and alleviate painful symptoms present a heavy emotional and financial burden to patients, families, and healthcare facilities.