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Vol. 91, No. 3, 2013
Issue release date: May 2013
Section title: Laboratory Investigation
Stereotact Funct Neurosurg 2013;91:153-161
(DOI:10.1159/000345270)

Strategies for the Delivery of Multiple Collinear Infusion Clouds in Convection-Enhanced Delivery in the Treatment of Parkinson's Disease

Sillay K. · Hinchman A. · Kumbier L. · Schomberg D. · Ross C. · Kubota K. · Brady M. · Brodsky E. · Miranpuri G. · Raghavan R.
Departments of aNeurological Surgery and bBiomedical Engineering, University of Wisconsin, Madison, Wisc., cEngineering Resources Group, Pembroke Pines, Fla., dKinetics Foundation, Los Altos, Calif., and eTherataxis, Baltimore, Md., USA

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Article / Publication Details

First-Page Preview
Abstract of Laboratory Investigation

Received: 12/21/2011
Accepted: 10/15/2012
Published online: 2/27/2013

Number of Print Pages: 9
Number of Figures: 4
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN

Abstract

Background: Delivery of multiple collinear payloads utilizing convection-enhanced delivery (CED) has historically been performed by retraction of a needle or catheter from the most distal delivery site. Few studies have addressed end-infusion morphology and associated payload reflux in stacked and collinear infusions, and studies comparing the advancement with the retraction mode are lacking. Objective: To compare advancement versus retraction mode infusion results. Methods: Infusion cloud pairs were created with the advancement and retraction technique in agarose gel using both open end-port SmartFlow™ (SF) and valve tip (VT) catheter infusion systems. Backflow, radius of infusion, and morphology were assessed. Results: Infusions with the SF catheter, in contrast to the VT catheter, exhibited significantly more backflow in retraction mode at the shallow infusion site. Infusion morphology differed with the second infusion after retraction: the infusate at the proximal site first filling the channel left by the retraction and then being convected into gel in a pronouncedly non-spherical shape during the second infusion. Conclusions: Significant differences in cloud morphology were noted with respect to external catheter geometry with retraction versus penetration between infusions in an agarose gel model of the brain. Further study is warranted to determine optimal protocols for human clinical trials employing CED with multiple collinear payloads.


Article / Publication Details

First-Page Preview
Abstract of Laboratory Investigation

Received: 12/21/2011
Accepted: 10/15/2012
Published online: 2/27/2013

Number of Print Pages: 9
Number of Figures: 4
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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    External Resources

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  14. Ivan ME, Martin A, Starr PA, Sootsman K, Larson PS: Brain shift analysis during burr hole based procedures using interventional MRI. J Neurosurg 2006;104:A659.