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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Polyvinylpyrrolidone-coated catheters decrease choroid plexus adhesion and improve flow/pressure performance in an in

Seunghyun Lee1, Jenna Ledbetter1, Jordan Davies2

  • 1CHOC Children's Research Institute, CHOC Neuroscience Institute, 1201 W. La Veta Avenue, Orange, CA, 92868, USA.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|July 7, 2023
PubMed

Insights

Polyvinylpyrrolidone (PVP) coated catheters demonstrated reduced cellular adhesion and improved flow compared to other types. These findings suggest PVP catheters may decrease shunt failure in pediatric hydrocephalus patients.

Area of Science:

  • Biomaterials Science
  • Pediatric Neurosurgery
  • Medical Device Engineering

Background:

  • Proximal catheter obstruction is a primary cause of ventricular shunt failure in pediatric hydrocephalus.
  • Recurrent shunt malfunction necessitates multiple revision surgeries, increasing patient morbidity.

Purpose of the Study:

  • To evaluate in vitro cellular adhesion and obstruction characteristics of different ventricular shunt catheter materials.
  • To compare the performance of polyvinylpyrrolidone (PVP) coated, antibiotic-impregnated, barium-stripe, and barium-impregnated catheters.

Main Methods:

  • Four distinct catheter types were tested for cellular adhesion using choroid plexus epithelial cells.
  • Catheter flow and pressure performance were assessed in a 3D-printed ventricular phantom system under simulated cerebrospinal fluid (CSF) flow.
  • Differential pressure sensors measured catheter performance under conditions mimicking choroid plexus growth.

Main Results:

  • Polyvinylpyrrolidone (PVP) coated catheters exhibited significantly lower median cell attachment (10 cells) compared to other types.
  • PVP catheters (-0.247 cm H2O) and antibiotic-impregnated catheters (-1.15 cm H2O) required significantly less differential pressure for consistent flow.
  • Barium-stripe (0.167 cm H2O) and barium-impregnated (0.618 cm H2O) catheters showed higher pressure differentials.

Conclusions:

  • PVP coated catheters demonstrated superior resistance to cellular adhesion and facilitated better flow dynamics.
  • Both PVP and antibiotic-impregnated catheters required less differential pressure, indicating improved performance.
  • The study suggests that PVP ventricular catheters hold clinical promise for reducing recurrent obstruction in pediatric patients.
Abstract

Keywords:
BioGlide catheterHydrocephalusProximal catheter malfunction

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