Refill Procedures of Intrathecal Drug Delivery Systems With a Recessed Fill Port on the Pump Surface: A Prospective Comparison Study of Ultrasound-Guided vs. Blind Refill Technique

Maino, Paolo; Kuijk, Sander M. J. van; Pérez, Roberto; Koetsier, Eva

doi:10.1111/ner.12849

Cited by 6 publications

(8 citation statements)

References 21 publications

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“…Therefore, the needle has to pass less subcutaneous tissue before entering the RFP, reducing the risk for needle deviation and possibly rendering needle access more easy. This hypothesis is sustained by previous studies, results of which suggested that a more deeply located RFP leads to significantly more needle attempts and a higher procedural time to enter the RFP …”

Section: Discussionsupporting

confidence: 58%

“…It was hypothesized that this difference was caused by the bump in the skin that is created by the raised RFP, which causes an insufficient plate support to the US probe, and might therefore hinder the US‐guided technique in the raised‐RFP‐IDDS. The results of another recently published study suggest that there is no difference in RFP needle access efficiency between the US‐guided and the blind refill technique in recessed‐RFP‐IDDSs . However, neither study addressed efficiency of RFP needle access in IDDSs with aberrancy location or refills performed by inexperienced staff .…”

Section: Discussionmentioning

confidence: 97%

“…The results of another recently published study suggest that there is no difference in RFP needle access efficiency between the US‐guided and the blind refill technique in recessed‐RFP‐IDDSs . However, neither study addressed efficiency of RFP needle access in IDDSs with aberrancy location or refills performed by inexperienced staff . The use of US guidance therefore remains recommended in IDDSs with difficult‐to‐access RFPs, such as in cases of deeply located or rotated pumps, the presence of fluid collections, or scar formation …”

Section: Discussionmentioning

confidence: 99%

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Refill Port Identification of Intrathecal Drug Delivery System Devices With a Raised Fill Port

2019

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Objectives The aim of this study was to assess the accuracy of the manual identification of the reservoir fill port (RFP) for refill of intrathecal drug delivery systems (IDDSs) with a raised RFP on the pump surface (raised‐RFP‐IDDSs), and compare this to previously reported data of patients with IDDSs with a recessed RFP (recessed‐RFP‐IDDSs). Methods Nineteen patients underwent 2 IDDS refills for the treatment of noncancer pain or spasticity. The primary endpoint of this prospective observational study was the deviation between the needle insertion point and the RFP center, quantified by fluoroscopic visualization. A distance surpassing that between the center and the margin of the RFP of 4 mm was considered a clinically relevant deviation. The results were compared with previously reported data of a patient cohort with recessed‐RFP‐IDDSs, and the differences were tested using Student's t‐test. Results The mean deviation from the RFP center was 4.9 mm (standard deviation = 3.7). The RFP identification accuracy deviated more than the clinically relevant difference in 17 out of 35 instances (48.6%). The number of attempts and median procedural time was significantly correlated to the needle deviation. The mean deviations in the raised‐RFP‐IDDS cohort were consistently lower compared to the recessed‐RFP‐IDDS cohort (first refill procedure 4.0 vs. 8.5, P < 0.001; second procedure 5.9 vs. 8.1, P = 0.074). Conclusion The results of this study suggest that the manual localization of the RFP for raised‐RFP‐IDDSs is moderately accurate, and more accurate if compared to previously published accuracy of the template‐guided technique for recessed‐RFP‐IDDSs.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Refill Port Identification of Intrathecal Drug Delivery System Devices With a Raised Fill Port

2019

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“…The accessibility of reservoir using template/manual identification or ultrasound-guided technique was also assessed in recessed-RAP (12) and raised septum pumps (12). The manual identification was found to be superior to ultrasound guidance in pumps with a raised septum.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Template Versus Ultrasound Identification of the Reservoir Access Port of Intrathecal Drug Delivery System

Matthys

Jacobs

Rossat

et al. 2020

Neuromodulation: Technology at the Neural Interface

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“…The results of another recently published study suggest that there is no difference in RFP needle access efficiency between the US-guided and the blind refill technique in recessed RFP-IDDSs. 3 However, neither study addressed the efficiency of RFP needle access in IDDSs with aberrant pump location or refills performed by inexperienced staff. 2,3 The use of US guidance therefore remains recommended in IDDSs with difficult-to-access RFPs, such as in cases of deeply located or rotated pumps, the presence of fluid collections, or scar formation.…”

Section: To the Editormentioning

confidence: 99%

Reply to Letter to the Editor Regarding Sonographic Assistance for Intrathecal Drugs Delivery System Refill

Maino

Koetsier

2019

Pain Practice

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Refill Procedures of Intrathecal Drug Delivery Systems With a Recessed Fill Port on the Pump Surface: A Prospective Comparison Study of Ultrasound-Guided vs. Blind Refill Technique

Cited by 6 publications

References 21 publications

Refill Port Identification of Intrathecal Drug Delivery System Devices With a Raised Fill Port

Refill Port Identification of Intrathecal Drug Delivery System Devices With a Raised Fill Port

Accuracy of Template Versus Ultrasound Identification of the Reservoir Access Port of Intrathecal Drug Delivery System

Reply to Letter to the Editor Regarding Sonographic Assistance for Intrathecal Drugs Delivery System Refill

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