Castañeyra-Ruiz Leandro, Lee Seunghyun, Chan Alvin Y, Shah Vaibhavi, Romero Bianca, Ledbetter Jenna, Muhonen Michael
CHOC Children's Research Institute, and CHOC Neuroscience Institute, 1201 W. La Veta Avenue, Orange, CA 92868, USA.
Neurosurgery Department, CHOC Children's Hospital, 505 S Main St., Orange, CA 92868, USA.
Children (Basel). 2022 Dec 22;10(1):18. doi: 10.3390/children10010018.
The leading cause of ventricular shunt failure in pediatric patients is proximal catheter occlusion. Here, we evaluate various types of shunt catheters to assess in vitro cellular adhesion and obstruction. The following four types of catheters were tested: (1) antibiotic- and barium-impregnated, (2) polyvinylpyrrolidone, (3) barium stripe, and (4) barium impregnated. Catheters were either seeded superficially with astrocyte cells to test cellular adhesion or inoculated with cultured astrocytes into the catheters to test catheter performance under obstruction conditions. Ventricular catheters were placed into a three-dimensional printed phantom ventricular replicating system through which artificial CSF was pumped. Differential pressure sensors were used to measure catheter performance. Polyvinylpyrrolidone catheters had the lowest median cell attachment compared to antibiotic-impregnated (18 cells), barium stripe (17 cells), and barium-impregnated (21.5 cells) catheters after culture (p < 0.01). In addition, polyvinylpyrrolidone catheters had significantly higher flow in the phantom ventricular system (0.12 mL/min) compared to the antibiotic coated (0.10 mL/min), barium stripe (0.02 mL/min) and barium-impregnated (0.08 mL/min; p < 0.01) catheters. Polyvinylpyrrolidone catheters showed less cellular adhesion and were least likely to be occluded by astrocyte cells. Our findings can help suggest patient-appropriate proximal ventricular catheters for clinical use.
小儿患者脑室分流失败的主要原因是近端导管阻塞。在此，我们评估了各种类型的分流导管，以评估体外细胞粘附和阻塞情况。测试了以下四种类型的导管：（1）含抗生素和钡剂的，（2）聚乙烯吡咯烷酮的，（3）钡条的，以及（4）含钡剂的。导管要么表面接种星形胶质细胞以测试细胞粘附，要么将培养的星形胶质细胞接种到导管中以测试阻塞条件下的导管性能。将脑室导管放入三维打印的模拟脑室复制系统中，通过该系统泵送人工脑脊液。使用差压传感器测量导管性能。培养后，与含抗生素（18个细胞）、钡条（17个细胞）和含钡剂（21.5个细胞）的导管相比，聚乙烯吡咯烷酮导管的中位细胞附着量最低（p < 0.01）。此外，与抗生素涂层（0.10 mL/min）、钡条（0.02 mL/min）和含钡剂（0.08 mL/min；p < 0.01）的导管相比，聚乙烯吡咯烷酮导管在模拟脑室系统中的流量显著更高（0.12 mL/min）。聚乙烯吡咯烷酮导管显示出较少的细胞粘附，并且最不容易被星形胶质细胞阻塞。我们的研究结果有助于为临床使用推荐适合患者的近端脑室导管。
