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Catheter systems for intrathecal drug delivery
R D Penn1, M M York, J A Paice
1Department of Neurosurgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
Journal of Neurosurgery
|August 1, 1995
Summary
Intrathecal catheter complications are common in patients receiving baclofen for spasticity. Thin-walled catheters frequently malfunction, suggesting a need for more durable, thick-walled alternatives for improved reliability.
Area of Science:
- Neurosurgery
- Biomedical Engineering
- Pharmacology
Background:
- Chronic spasticity management often involves intrathecal baclofen therapy.
- Implanted drug pumps deliver medication directly into the cerebrospinal fluid.
- Catheter reliability is crucial for effective and safe long-term treatment.
Purpose of the Study:
- To prospectively evaluate the reliability of intrathecal catheters used for chronic baclofen administration.
- To identify the incidence and types of catheter complications.
- To determine factors influencing catheter survival and malfunction.
Main Methods:
- Prospective study including 102 patients receiving intrathecal baclofen for spasticity.
- Data collection on catheter complications over the course of treatment.
- Survival analysis to assess time to first catheter failure.
Main Results:
- 60% of patients experienced no catheter complications.
- The remaining 40% had one to five complications.
- Mean time to first catheter failure was 20 months, with malfunction rates steady up to 80 months.
- Common complications included kinks, holes, breaks, dislodgments, and disconnections.
Conclusions:
- Thin-walled silastic intrathecal catheters demonstrate poor performance and reliability.
- Larger, thick-walled catheters are recommended to improve device durability and reduce complications.
- Optimizing catheter design is essential for long-term intrathecal drug delivery systems.