Flow Analysis of Cerebrospinal Fluid inside Catheters used for Hydrocephalus Patients According to Brain MRI Image by Means of CFD

Document Type : Research Article

Author

Biomedical Engineering Department, Faculty of Chemical Engineering, Tarbiat Modares University, tehran, iran

Abstract

(1) The treatment of hydrocephalus is the use of cerebrospinal shunts. These shunts are made up of different parts. One of the most important parts of these shunts is their catheter, which is placed inside the ventricle of the brain in order to drain cerebrospinal fluid. One of the most important problems of ventricular catheters is their clogging, which causes shunt replacement in 50-80% cases. Although many factors affect this congestion, one of the most important of them is the flow inside the ventricles of the brain with hydrocephalus; (2) Methods: The works of many researchers have mentioned the problem of flow inside the catheters, for this purpose two-dimensional simulation has been used. In this research, the two-dimensional image obtained through MRI has been used in the simulation in order to influence the real shape of the ventricles of the brain in the occlusion of the ventricular catheters; (3) Results: According to the investigations, the cause of clogging of most common catheters is the problem in the morphology and the way their holes are located; (4) Conclusions: A new design of catheters by changing the diameter and slope of the holes has been presented. It was found that conventional catheters are very susceptible to being closed by dead cells or cerebral ventricular tissue. Four types of catheters were examined, types 3 and 4 showed better performance with 50% and types 5 and 6 with 100% reduction in the probability of catheter hole closure.

Keywords


[1] Naderpour, H., Kheyroddin, A., Amiri, G.G., 2010. Prediction of FRP-confined compressive strength of concrete using artificial neural networks, Composite Structures,  92(12), 2817-2829. https://doi.org/10.1016/j.compstruct.2010.04.008.
[2] Payr, E., 1908. Drainage der Hirnventrikel mittelst frei transplantirter Blutgefasse; Bemerkungen über Hydrocephalus, Arch Klin Chir,  87, 801-885. https://doi.org/10.3171/jns.1954.11.3.0284.
[3] Tuli, S., Drake, J., Lawless, J., Wigg, M., Lamberti-Pasculli, M., 2000. Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus, Journal of neurosurgery,  92(1), 31-38. https://doi.org/10.3171/jns.2000.92.1.0031.
[4] Drake, J.M., Kestle, J.R., Milner, R., Cinalli, G., Boop, F., Piatt Jr, J., Haines, S., Schiff, S.J., Cochrane, D.D., Steinbok, P., 1998. Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus, Neurosurgery,  43(2), 294-303. https://doi.org/10.4103/sni.sni_11_17.
[5] Kahle, K.T., Klinge, P.M., Koschnitzky, J.E., Kulkarni, A.V., MacAulay, N., Robinson, S., Schiff, S.J., Strahle, J.M., 2024. Paediatric hydrocephalus, Nature Reviews Disease Primers,  10(1), 35. https://doi.org/10.1038/s41572-024-00519-9.
[6] Hariharan, P., Gluski, J., Sondheimer, J., Petroj, A., Jea, A., Whitehead, W.E., Del Bigio, M.R., Marupudi, N.I., McAllister, J.P., Limbrick, D.D., 2023. Exploration of clinical predictors of the degree of ventricular catheter obstruction: a multicenter retrospective study, Journal of Neurosurgery: Pediatrics,  32(4), 447-454. https://doi.org/10.3171/2023.5.PEDS22552.
[7] Garcia-Bonilla, M., Hariharan, P., Gluski, J., Ruiz-Cardozo, M.A., Otun, A., Morales, D.M., Marupudi, N.I., Whitehead, W.E., Jea, A., Rocque, B.G., 2024. Ventricular catheter tissue obstruction and shunt malfunction in 9 hydrocephalus etiologies, Journal of Neurosurgery: Pediatrics,  1(aop), 1-10. https://doi.org/10.3171/2024.2.PEDS23356.
[8] Sainte-Rose, C., Piatt, J., Renier, D., Pierre-Kahn, A., Hirsch, J., Hoffman, H., Humphreys, R., Hendrick, E., 1991. Mechanical complications in shunts, Pediatric neurosurgery,  17(1), 2-9. https://doi.org/10.1159/000120557.
[9] Gopalakrishnan, P., Faryami, A., Harris, C.A., 2023. A novel, benchtop model for quantitative analysis of resistance in ventricular catheters, Plos one,  18(11), e0294811. https://doi.org/10.1371/journal.pone.0294811.
[10] Harris, C.A., McAllister, J.P., 2012. What we should know about the cellular and tissue response causing catheter obstruction in the treatment of hydrocephalus, Neurosurgery,  70(6), 1589-1602. https://doi.org/10.3171/jns.2003.99.2.0426.
[11] Aghayev, K., Iqbal, S.M., Asghar, W., Shahmurzada, B., Vrionis, F.D., 2021. Advances in CSF shunt devices and their assessment for the treatment of hydrocephalus, Expert Review of Medical Devices,  18(9), 865-873. https://doi.org/10.1080/17434440.2021.1962289.
[12] Lin, J., Morris, M., Olivero, W., Boop, F., Sanford, R.A., 2003. Computational and experimental study of proximal flow in ventricular catheters, Journal of neurosurgery,  99(2), 426-431. https://doi.org/10.3171/jns.2003.99.2.0426.
[13] Khodadadei, F., Liu, A.P., Harris, C.A., 2021. A high-resolution real-time quantification of astrocyte cytokine secretion under shear stress for investigating hydrocephalus shunt failure, Communications biology,  4(1), 387. https://doi.org/10.1038/s42003-021-01888-7.
[14] Abrofarakh, M., Moghadam, H., 2024. Investigation of thermal performance and entropy generation rate of evacuated tube collector solar air heater with inserted baffles and metal foam: a CFD approach, Renewable Energy,  223, 120022. https://doi.org/10.1016/j.renene.2024.120022.
[15] Abrofarakh, M., Moghadam, H., Abdulrahim, H.K., 2024. Investigation of direct contact membrane distillation (DCMD) performance using CFD and machine learning approaches, Chemosphere,  357, 141969. https://doi.org/10.1016/j.chemosphere.2024.141969.
[16] Galarza, M., Giménez, Á., Valero, J., Pellicer, O.P., Amigó, J.M., 2014. Computational fluid dynamics of ventricular catheters used for the treatment of hydrocephalus: a 3D analysis, Child's Nervous System,  30, 105-116. https://doi.org/10.1007/s00381-013-2226-1.
[17] Podgoršak, A., Flürenbrock, F., Trimmel, N.E., Korn, L., Oertel, M.F., Stieglitz, L., Fernandes Dias, S., Hierweger, M.M., Zeilinger, M., Weisskopf, M., Toward the “Perfect” Shunt: Historical Vignette, Current Efforts, and Future Directions, Advances and Technical Standards in Neurosurgery: Volume 50, Springer2024, pp. 1-30.
[18] Galarza, M., Giménez, Á., Pellicer, O., Valero, J., Amigó, J.M., 2015. New designs of ventricular catheters for hydrocephalus by 3-D computational fluid dynamics, Child's Nervous System,  31, 37-48. https://doi.org/10.1007/s00381-014-2477-5.
[19] Galarza, M., Giménez, Á., Valero, J., Pellicer, O., Martínez-Lage, J.F., Amigó, J.M., 2015. Basic cerebrospinal fluid flow patterns in ventricular catheters prototypes, Child's Nervous System,  31, 873-884. https://doi.org/10.1007/s00381-015-2651-4.
[20] Penn, R.D., Basati, S., Sweetman, B., Guo, X., Linninger, A., 2011. Ventricle wall movements and cerebrospinal fluid flow in hydrocephalus, Journal of neurosurgery,  115(1), 159-164. https://doi.org/10.3171/2010.12.JNS10926.
[21] Giménez, Á., Galarza, M., Thomale, U., Schuhmann, M., Valero, J., Amigó, J., 2017. Pulsatile flow in ventricular catheters for hydrocephalus, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences,  375(2096), 20160294. https://doi.org/10.1098/rsta.2016.0294.
[22] Cheng, S., Jacobson, E., Bilston, L., 2007. Models of the pulsatile hydrodynamics of cerebrospinal fluid flow in the normal and abnormal intracranial system, Computer methods in biomechanics and biomedical engineering,  10(2), 151-157. https://doi.org/10.1080/10255840601124753.
[23] Kurtcuoglu, V., Poulikakos, D., Ventikos, Y., 2005. Computational modeling of the mechanical behavior of the cerebrospinal fluid system. Journal of Biomechanical Engineering, 127(2), 264-269. https://doi.org/10.1115/1.1865191.
[24] Vastani, A., Al-Faiadh, W., O Chieng, D., Siddiqui, A., Bleil, C., Singh, R., Zebian, B., 2023. Obstructive hydrocephalus due to an enlarged massa intermedia treated with endoscopic third ventriculostomy, British Journal of Neurosurgery, 1-4. https://doi.org/10.1080/02688697.2022.2159924.
[25] Chatterjee, K., Carman-Esparza, C.M., Munson, J.M., 2020. Methods to measure, model and manipulate fluid flow in brain, Journal of neuroscience methods,  333, 108541. https://doi.org/10.1016/j.jneumeth.2019.108541.
[26] Ursino, M., 1988. A mathematical study of human intracranial hydrodynamics part 1—the cerebrospinal fluid pulse pressure, Annals of biomedical engineering,  16, 379-401. https://doi.org/10.1007/BF02364625.
[27] Aroussi, A., Howden, L., Vioeberghs, M., 3D visualisation of cerebrospinal fluid flow within the human central nervous system, The 2nd International Conference on Distributed Frameworks for Multimedia Applications, IEEE, 2006, pp. 1-7.
[28] Gholampour, S., Fatouraee, N., 2021. Boundary conditions investigation to improve computer simulation of cerebrospinal fluid dynamics in hydrocephalus patients, Communications biology,  4(1), 394. https://doi.org/10.1038/s42003-021-01920-w.
[29] Linninger, A.A., Tsakiris, C., Zhu, D.C., Xenos, M., Roycewicz, P., Danziger, Z., Penn, R., 2005. Pulsatile cerebrospinal fluid dynamics in the human brain, IEEE Transactions on Biomedical Engineering,  52(4), 557-565. https://doi.org/10.1109/TBME.2005.844021.
[30] Thomale, U.W., Hosch, H., Koch, A., Schulz, M., Stoltenburg, G., Haberl, E.-J., Sprung, C., 2010. Perforation holes in ventricular catheters—is less more?, Child's Nervous System,  26, 781-789. https://doi.org/10.1007/s00381-009-1055-8.