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Polyvinylpyrrolidone-Coated Catheters Decrease Astrocyte Adhesion and Improve Flow/Pressure Performance in an Invitro
Leandro Castañeyra-Ruiz1, Seunghyun Lee1, Alvin Y Chan2
1CHOC Children's Research Institute, and CHOC Neuroscience Institute, 1201 W. La Veta Avenue, Orange, CA 92868, USA.
Insights
Polyvinylpyrrolidone catheters demonstrate reduced cellular adhesion and obstruction, offering a promising solution for preventing ventricular shunt failure in pediatric patients. These findings aid in selecting optimal catheters for clinical use.
Area of Science:
- Biomedical Engineering
- Neurosurgery
- Materials Science
Background:
- Proximal catheter occlusion is a primary cause of ventricular shunt failure in pediatric hydrocephalus.
- Current shunt catheter materials vary in their susceptibility to cellular adhesion and obstruction.
Purpose of the Study:
- To evaluate and compare the in vitro cellular adhesion and obstruction characteristics of four different ventricular shunt catheter types.
- To identify shunt catheter designs that minimize cellular adhesion and obstruction for improved clinical performance.
Main Methods:
- Four catheter types (antibiotic- and barium-impregnated, polyvinylpyrrolidone, barium stripe, barium impregnated) were tested.
- Cellular adhesion was assessed by seeding catheters with astrocyte cells.
- Obstruction was evaluated using a 3D-printed ventricular phantom system with artificial cerebrospinal fluid (CSF) flow and differential pressure sensors.
Main Results:
- Polyvinylpyrrolidone (PVP) catheters exhibited significantly lower median cell attachment compared to other tested catheters (p < 0.01).
- PVP catheters demonstrated significantly higher flow rates (0.12 mL/min) in the phantom system than antibiotic-coated (0.10 mL/min), barium stripe (0.02 mL/min), and barium-impregnated (0.08 mL/min) catheters (p < 0.01).
- PVP catheters showed reduced cellular adhesion and were least prone to obstruction by astrocyte cells.
Conclusions:
- Polyvinylpyrrolidone catheters present superior performance regarding reduced cellular adhesion and obstruction.
- These findings support the clinical use of PVP catheters to mitigate ventricular shunt failure in pediatric populations.
- Optimizing catheter material selection can enhance the longevity and efficacy of shunting procedures for hydrocephalus.
Abstract:
The leading cause of ventricular shunt failure in pediatric patients is proximal catheter occlusion. Here, we evaluate various types of shunt catheters to assess in vitro cellular adhesion and obstruction. The following four types of catheters were tested: (1) antibiotic- and barium-impregnated, (2) polyvinylpyrrolidone, (3) barium stripe, and (4) barium impregnated. Catheters were either seeded superficially with astrocyte cells to test cellular adhesion or inoculated with cultured astrocytes into the catheters to test catheter performance under obstruction conditions. Ventricular catheters were placed into a three-dimensional printed phantom ventricular replicating system through which artificial CSF was pumped. Differential pressure sensors were used to measure catheter performance. Polyvinylpyrrolidone catheters had the lowest median cell attachment compared to antibiotic-impregnated (18 cells), barium stripe (17 cells), and barium-impregnated (21.5 cells) catheters after culture (p < 0.01). In addition, polyvinylpyrrolidone catheters had significantly higher flow in the phantom ventricular system (0.12 mL/min) compared to the antibiotic coated (0.10 mL/min), barium stripe (0.02 mL/min) and barium-impregnated (0.08 mL/min; p < 0.01) catheters. Polyvinylpyrrolidone catheters showed less cellular adhesion and were least likely to be occluded by astrocyte cells. Our findings can help suggest patient-appropriate proximal ventricular catheters for clinical use.
