Lee Seunghyun, Vinzani Michael, Romero Bianca, Chan Alvin Y, Castañeyra-Ruiz Leandro, Muhonen Michael
CHOC Children's Research Institute, 1201 W. La Veta Avenue, Orange, CA 92868, USA.
College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Children (Basel). 2022 Sep 23;9(10):1453. doi: 10.3390/children9101453.
One of the major causes of cerebral ventricular shunt failure is proximal catheter occlusion. We describe a novel ventricular cerebrospinal fluid (CSF) flow replicating system that assesses pressure and flow responses to varying degrees of catheter occlusion.
Ventricular catheter performance was assessed during conditions of partial and complete occlusion. The catheters were placed into a three-dimensionally-printed phantom ventricular replicating system. Artificial CSF was pumped through the ventricular system at a constant rate of 1 mL/min to mimic CSF flow, with the proximal end of the catheter in the phantom ventricle. Pressure transducer and flow rate sensors were used to measure intra-phantom pressure, outflow pressure, and CSF flow rates. The catheters were also inserted into silicone tubing and pressure was measured in the same manner for comparison with the phantom.
Pressure measured in the ventricle phantom did not change when the outflow of the ventricular catheter was partially occluded. However, the intraventricular phantom pressure significantly increased when the outflow catheter was 100% occluded. The flow through the catheter showed no significant difference in rate with any degree of partial occlusion of the catheter. At the distal end of the partially occluded catheters, there was less pressure compared with the nonoccluded catheters. This difference in pressure in partially occluded catheters correlated with the percentage of catheter hole occlusion.
Our model mimics the physiological dynamics of the CSF flow in partially and completely obstructed ventricular catheters. We found that partial occlusion of the catheter had no effect on the CSF flow rate, but did reduce outflow pressure from the catheter.
脑室分流失败的主要原因之一是近端导管堵塞。我们描述了一种新型的脑室脑脊液（CSF）流动复制系统，该系统可评估对不同程度导管堵塞的压力和流量反应。
在部分和完全堵塞的情况下评估脑室导管性能。将导管放入三维打印的模拟脑室复制系统中。以1 mL/分钟的恒定速率将人工脑脊液泵入脑室系统以模拟脑脊液流动，导管近端置于模拟脑室中。使用压力传感器和流速传感器测量模拟脑室内压力、流出压力和脑脊液流速。导管也插入硅胶管中，并以相同方式测量压力以与模拟物进行比较。
当脑室导管流出部分堵塞时，模拟脑室内测得的压力没有变化。然而，当流出导管100%堵塞时，脑室内模拟压力显著增加。导管流量在导管任何程度的部分堵塞时速率无显著差异。在部分堵塞导管的远端，与未堵塞导管相比压力较小。部分堵塞导管中的这种压力差异与导管孔堵塞百分比相关。
我们的模型模拟了部分和完全堵塞的脑室导管中脑脊液流动的生理动态。我们发现导管的部分堵塞对脑脊液流速没有影响，但确实降低了导管的流出压力。
