Novel Shunt System for Endovascular Management of Obstructive Hydrocephalous

Abstract

Our capstone team has worked in order to develop a 3-dimensional steerable catheter system for the placement of an endovascular shunt to treat obstructive hydrocephalus. Hydrocephalus occurs when a buildup of Cerebrospinal Fluid (CSF) in the brain’s ventricles causes them to expand, restricting blood flow to surrounding brain tissue. Current solutions often involve intense surgical procedures such as the drilling of a burr hole into the skull, which have long recovery times and high infection rates. An endovascular procedure for the placement of a shunt aims to address both of these limitations. In order to accomplish this our team came up with a coaxial system design that includes an outermost balloon guidecatheter, deflectable microcatheter, supportive dilator, styleted needle, and innermost guidewire. This delivery system will be inserted through the internal jugular vein, pierce through the transverse sinus, and anchor in the occipital horn of the lateral ventricles, where the shunt will be placed. We developed an interlocking guidecatheter-microcatheter apparatus to provide 3D steering to our system. We also utilized a balloon guide catheter to anchor the system in place and oppose resistance during the puncturing of the transverse sinus. After this the guidewire will traverse through the brain tissue with the support of the dilator via an inchworming process. Our team modeled this process in our prototyping, showing the effectiveness of the supportive dilator during inchworming. We found the use of the dilator to provide more consistent results and fewer off-target effects during the inchworming process.

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