Technical Advances in the Treatment of Hydrocephalus: Current and Future State

Hauptman, Jason S.; Lutz, Barry; Hanak, Brian W.; Browd, Samuel R.

doi:10.1007/978-3-319-97928-1_21

Cited by 2 publications

(1 citation statement)

References 89 publications

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“…Another principally different endovascular system for leaving the blood vessels is the eShunt system. No peer review articles are currently published but it has been presented at conferences as a method for exiting veins at the jugular bulb at the skull base level to place a draining catheter in the subarachnoid space for hydrocephalus treatment .…”

Section: Current Devices That Are Designed To Penetrate the Vessel Wallmentioning

confidence: 99%

The creation of an endovascular exit through the vessel wall using a minimally invasive working channel in order to reach all human organs

2019

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Since the establishment of the Seldinger technique for secure entry to the vascular system, there has been a rapid evolution in imaging and catheters that has made the arteries and veins internal routes to any place in the body for interventions. It is curious that a general exit from the vasculature in a similar manner has not been proposed earlier. Possibly, the simplest reason is that accidental perforation of the vasculature by guide wire or catheter is a feared adverse event in endovascular intervention. Most places in the body can be reached by ultrasonography or computed tomography‐guided intervention. Some organs such as the central nervous system, the heart and pancreas are harder to access and, in some organs, like the kidney, repeated percutaneous punctions to cover large areas is not suitable. We present a new general purpose micro‐endovascular device creating a working channel to these ‘hard to reach’ organs by an inverted Seldinger technique. This review details this trans‐vessel wall technique, which has been studied in pancreas for transplantation of insulin‐producing cells, for injection of contrast agent to the heart and to the brain, bowels and kidney in rat, rabbit, swine and macaque monkeys with up to one year of follow‐up without adverse events. Furthermore, the payloads that can be given through such a system are briefly discussed. Drugs, cells, gene vectors and other therapeutic substances may be injected directly to the tissue to increase efficacy and decrease risk of off‐site adverse effects.

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Section: Current Devices That Are Designed To Penetrate the Vessel Wallmentioning

confidence: 99%