The Movement Disorder Society

MDS 17th International Congress of Parkinson's Disease and Movement Disorders, Volume 28,
June 2013 Abstract Supplement

Movement Disorders 2013
Sydney, Australia June 16-20, 2013.


Real-time monitoring for systematic investigation of catheter design and infusion protocol effect on CED performance

Grabow ,  B., Kubota ,  K., Raghavan ,  R., Brady ,  M., Ross ,  C., Hurley ,  S., Brodsky ,  E., Raschke ,  J., Alexander ,  A., Block ,  W.

Los Altos, CA, USA

Objective:

Convection Enhanced Delivery (CED) is a neurosurgical procedure for delivering possible new treatments for Parkinson's disease. MRI guidance of CED has proven beneficial [1]. However, the field would benefit from a generalizable understanding on how several variables within catheter design and infusion protocols influence drug distribution.

Background:

Backflow along the catheter exterior alters the initial drug delivery point from the catheter tip, which produces a desired spherical drug distribution, to a variable length line, which produces a varied cylindrical distribution. Our study investigates how to reduce backflow through catheter and infusion design.

Methods:

Infusions were targeted and delivered bilaterally in vivo to the thalamus of 15 pigs. Rapid device targeting and insertion was performed via prospective stereotaxy [2], accelerated with an in-house developed software plug-in that enables real-time device manipulation and drug distribution monitoring.

Results:

Real-time device manipulation allows us to perform trajectory alignment in 2 min and perform an entire infusion in 1 hour. Our real-time MRI system enabled rapid performance while providing either dynamic time-resolved 2D images of infusion progression or 3D volumetric images of final infusion morphology. 2D real-time imaging along the catheter indicates that backflow occurs at its full length within the first few seconds of an infusion (Figure 1) not gradually as previously believed. In comparison to constant flow, ramped infusions showed no less likelihood of backflow.

Conclusions:

The ease and speed of the trajectory guidance system and the availability of time-resolved imaging during the infusion, has enabled us to undertake a systematic investigation that may influence the occurrence of backflow and ultimately drug distribution for future Parkinson's treatments.

REFERENCES

To cite this abstract, please use the following information:
Grabow, B., Kubota, K., Raghavan, R., Brady, M., Ross, C., Hurley, S., Brodsky, E., Raschke, J., Alexander, A., Block, W.; Real-time monitoring for systematic investigation of catheter design and infusion protocol effect on CED performance [abstract]. Movement Disorders 2013;28 Suppl 1 :104