SCIDOT-36. PREDICTIVE CED INFUSION VOLUMES FOR SURGICAL PLANNING AND INFUSION REGIME STRATEGIES. (11th November 2019)

• Record Type: Journal Article
• Authors: Killick-Cole, Clare; Woolley, Max; Johnson, David; Lewis, Owen; Skinner, Paul; Bienemann, Alison; Gill, Steven
• Is Part Of: Neuro-oncology. Volume 21(2019)Supplement 6
• Page Start: vi279
• Page End: vi279
• Publication Date: 2019-11-11
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noz175.1172
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: Previous research and clinical trials have highlighted the utility of convection-enhanced delivery (CED) to directly administer therapeutics to the brain. This method bypasses the blood-brain barrier, which is a major obstacle in systemic drug delivery. The Renishaw Neuroinfuse™ recessed step catheter has been developed to utilise a mechanism we have termed "controlled reflux" to maximise distribution within brain targets, whereby the infusate tracks to a flow inhibiting feature. Once in contact with this feature, the flow pathway is initiated radially along the step region, facilitating a low-pressure infusion profile that minimises fast flow-rate tissue damage at the catheter tip whilst maximising coverage. This can be demonstrated through in vitro studies, in vivo preclinical work and humanitarian cases treating DIPG. The controlled reflux mechanism provides a level of infusion prediction, which can be used for catheter placement planning in order to optimize infusion distribution within a chosen target area. The Neuroinfuse™ catheter is delivered through an implantable guide tube whereby the guide tube and the catheter lengths are cut to provide bespoke features within the controlled reflux zone. By manipulating catheter step lengths this way, catheters can be designed to achieve target distribution volumes within an individual's unique brain anatomy. Here we will present data demonstrating the utility of the acute catheter system, and its additional use as a modular component of the chronic drug delivery system. This modularisation strategy provides attributes for catheter placement and infusion distribution planning that spans across multiple indications for neuro-oncology and neurodegenerative diseases.