Intrathecal Drug Delivery by Implanted Pumps

Approaches to CNS Drug Delivery with a Focus on Transporter-Mediated Transcytosis

“…The therapeutic material is directly administered in one of the ventricles (intraventricular) or the spinal canal (intrathecal) as time-separated boluses via an internally implanted reservoir or a programmed pump (Figure 4) [32,33,34,35]. The therapeutic material reaches the brain and spinal cord tissues through the CSF [32,33,34,35]. Replenishment of the therapeutic material can be achieved by topping up the reservoir or replacing the pump [32,33,34,35].…”

“…The therapeutic material reaches the brain and spinal cord tissues through the CSF [32,33,34,35]. Replenishment of the therapeutic material can be achieved by topping up the reservoir or replacing the pump [32,33,34,35]. The installation of the catheter and the reservoir or the pump is performed surgically, thus, as with all surgical manipulations, there is a risk of tissue damage, accompanied with a loss of function, and tissue infection with the added recovery time of the patient [32,33,34,35].…”

“…Replenishment of the therapeutic material can be achieved by topping up the reservoir or replacing the pump [32,33,34,35]. The installation of the catheter and the reservoir or the pump is performed surgically, thus, as with all surgical manipulations, there is a risk of tissue damage, accompanied with a loss of function, and tissue infection with the added recovery time of the patient [32,33,34,35]. The extent of such risks can be reduced by careful planning of the operation, use of orthogonal technologies that can help visualize the route of implantation, and antibiotic prescription, if necessary [32].…”

“…The installation of the catheter and the reservoir or the pump is performed surgically, thus, as with all surgical manipulations, there is a risk of tissue damage, accompanied with a loss of function, and tissue infection with the added recovery time of the patient [32,33,34,35]. The extent of such risks can be reduced by careful planning of the operation, use of orthogonal technologies that can help visualize the route of implantation, and antibiotic prescription, if necessary [32]. In some cases, intraventricular or intrathecal drug administration is the most cost-effective approach for the treatment of chronic pain secondary to brain or spinal cord injury by sustaining a prolonged and stable state of analgesia without developing addiction or severe side effects, thereby improving patients’ quality of life [32].…”

“…The extent of such risks can be reduced by careful planning of the operation, use of orthogonal technologies that can help visualize the route of implantation, and antibiotic prescription, if necessary [32]. In some cases, intraventricular or intrathecal drug administration is the most cost-effective approach for the treatment of chronic pain secondary to brain or spinal cord injury by sustaining a prolonged and stable state of analgesia without developing addiction or severe side effects, thereby improving patients’ quality of life [32].…”