Prevention of Intrathecal Drug Delivery Catheter-Related Complications
In an effort to improve the performance of implantable intrathecal drug delivery systems, a group of physicians experienced in the management of such devices reviewed surgical practices and principles that were associated with low catheter‐related complication rates. Clinical study and postmarket da...
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Published in | Neuromodulation (Malden, Mass.) Vol. 6; no. 1; pp. 32 - 41 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Science Inc
01.01.2003
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Subjects | |
Online Access | Get full text |
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Summary: | In an effort to improve the performance of implantable intrathecal drug delivery systems, a group of physicians experienced in the management of such devices reviewed surgical practices and principles that were associated with low catheter‐related complication rates. Clinical study and postmarket data identified physicians whose patients experienced a relatively low rate of catheter‐related complications. Six of those physicians (three anesthesiologists and three neurosurgeons) reviewed the number and types of intrathecal drug pumps and catheters they had implanted, with an emphasis on the specific details of successful catheter implantation techniques. The authors pooled their experiences to reach a consensus on implant techniques that are associated with a low rate of postoperative complications.
The authors found that complications were minimized by the use of specific methods for catheter placement that included: a mid‐to‐upper lumbar dural entry level, a shallow‐angle paramedian oblique insertion trajectory, and meticulous catheter anchoring and tunneling techniques. Systemic antibiotic prophylaxis, attention to pump pocket location, and surgical wound closure techniques also were important in reducing the incidence of postoperative device‐related complications. Their experience indicates that specific implantation techniques using a variety of catheters and accessories can be expected to reduce the incidence of complications after implantation of intrathecal drug administration systems. |
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Bibliography: | ArticleID:NER3005 ark:/67375/WNG-VLLSW95P-4 istex:75D2170890BFBF92D508CC571E057FF09CCFCF09 The consensus conference upon which this manuscript is based was supported by an unrestricted educational grant from Medtronic, Inc., Minneapolis, MN. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1094-7159 1525-1403 |
DOI: | 10.1046/j.1525-1403.2003.03005.x |