Mehta A M, Sonabend A M, Bruce J N
Department of Neurological Surgery, Columbia University Medical Center, New York, NY, 10032, USA.
Neurotherapeutics. 2017 Apr;14(2):358-371. doi: 10.1007/s13311-017-0520-4.
Convection-enhanced delivery (CED) is a promising technique that generates a pressure gradient at the tip of an infusion catheter to deliver therapeutics directly through the interstitial spaces of the central nervous system. It addresses and offers solutions to many limitations of conventional techniques, allowing for delivery past the blood-brain barrier in a targeted and safe manner that can achieve therapeutic drug concentrations. CED is a broadly applicable technique that can be used to deliver a variety of therapeutic compounds for a diversity of diseases, including malignant gliomas, Parkinson's disease, and Alzheimer's disease. While a number of technological advances have been made since its development in the early 1990s, clinical trials with CED have been largely unsuccessful, and have illuminated a number of parameters that still need to be addressed for successful clinical application. This review addresses the physical principles behind CED, limitations in the technique, as well as means to overcome these limitations, clinical trials that have been performed, and future developments.
对流增强递送（CED）是一种很有前景的技术，它在输液导管尖端产生压力梯度，以直接通过中枢神经系统的间隙递送治疗药物。它解决了传统技术的许多局限性并提供了解决方案，能够以靶向且安全的方式递送药物越过血脑屏障，从而达到治疗药物浓度。CED是一种广泛适用的技术，可用于递送多种治疗化合物来治疗多种疾病，包括恶性胶质瘤、帕金森病和阿尔茨海默病。自20世纪90年代初开发以来，虽然已经取得了一些技术进步，但CED的临床试验在很大程度上并不成功，并且揭示了一些成功应用于临床仍需解决的参数。本综述阐述了CED背后的物理原理、该技术的局限性、克服这些局限性的方法、已进行的临床试验以及未来的发展。
