In Vitro Assessment of Ventricular Catheters with a Multilayered Fibrous Web to Prevent Cellular Occlusion

Hydrocephalus management generally requires the implantation of a cerebrospinal fluid (CSF) shunt system that includes a ventricular catheter, a mechanical valve to regulate CSF flow, and a distal catheter that diverts the CSF to another site in the body, most commonly the peritoneal cavity. Despite advancements, approximately 40% of these shunts fail within two years, primarily due to catheter occlusion caused by cell attachment and cellular debris. Previous strategies, including polyvinylpyrrolidone (PVP) coatings aimed at reducing bacterial adhesion, have not significantly mitigated occlusion rates in clinical settings. This study explores the development of ventricular shunt catheters with a multilayered fibrous web using electrospinning technique in an effort to mitigate cellular attachment and enhance shunt longevity. Commercial silicone catheters were coated with medical-grade polyurethane material and evaluated for cellular adhesion using human astrocytes and choroid plexus epithelium (ChPE). Cells were visualized through DAPI staining and immunolabeling, and cell counts were quantified using ImageJ. Results demonstrated a significant reduction in cellular adhesion on web-spun catheters compared to uncoated controls, with normalized astrocyte densities decreasing from 37.10 ± 18.44 to 24.39 ± 16.68 [cells/mm²] (p = 0.0329). These findings suggest that web-spun coatings hold promise for improving the reliability and lifespan of shunt systems by mitigating cellular occlusion.