4.4 Article

First-in-human endovascular treatment of hydrocephalus with a miniature biomimetic transdural shunt

Journal

JOURNAL OF NEUROINTERVENTIONAL SURGERY
Volume 14, Issue 5, Pages 495-+

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/neurintsurg-2021-018136

Keywords

hydrocephalus; intervention; intracranial pressure; catheter; technology

Funding

  1. CereVasc Inc.

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The novel minimally invasive endovascular cerebrospinal fluid shunt described in the text successfully treated intractable hydrocephalus in an octogenarian, rapidly reducing intracranial pressure and resolving ventriculomegaly. This first successful development of percutaneous transluminal venous access to the central nervous system provides a new pathway for non-invasive treatment of hydrocephalus and potential intervention against neurological disorders.
Surgical ventriculoperitoneal shunting remains standard treatment for communicating hydrocephalus, despite persistently elevated infection and revision rates. A novel minimally invasive endovascular cerebrospinal fluid (CSF) shunt was developed to mimic the function of the arachnoid granulation which passively filters CSF from the central nervous system back into the intracranial venous sinus network. The endovascular shunt is deployed via a femoral transvenous approach across the dura mater into the cerebellopontine angle cistern. An octogenarian with intractable hydrocephalus following subarachnoid hemorrhage underwent successful endovascular shunting, resulting in swift intracranial pressure reduction from 38 to <20 cmH(2)O (<90 min) and resolution of ventriculomegaly. This first successful development of a percutaneous transluminal venous access to the central nervous system offers a new pathway for non-invasive treatment of hydrocephalus and the potential for intervention against neurological disorders.

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