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Comparison between an Ascenda and a silicone catheter in intrathecal baclofen therapy in pediatric patients: analysis of complications.
J Neurosurg Pediatr. 2016 Oct; 18(4):493-498.JN

Abstract

OBJECTIVE

In this single-center study the authors investigated the complications occurring before and after the introduction of the new Ascenda intrathecal catheter (Medtronic Inc.) in pediatric patients treated with intrathecal baclofen therapy (ITB) for spasticity and/or dystonia.

METHODS

This was a retrospective review of 508 children who had received ITB, 416 with silicone catheters in the 13 years between September 1998 and September 2011 and 92 with Ascenda catheters in the 3 years between September 2011 and August 2014. The authors evaluated major complications such as infections, CSF leaks treated, and problems related to the catheter or pump, and they compared the 2 groups of patients who had received either a silicone catheter or an Ascenda catheter implant.

RESULTS

One hundred twenty patients in the silicone group (29%) and 1 patient in the Ascenda group (1.1%; p < 0.001) had a major complication. In the silicone group 23 patients (5.5%) were affected by CSF leakage and 75 patients (18%) experienced 82 catheter-related events, such as occlusion, dislodgment, disconnection, or breakage, which required catheter replacement. In the Ascenda group, only 1 patient (1.1%) was affected by CSF leakage.

CONCLUSIONS

To the authors' knowledge, this study is the first in the literature to compare the performance of the new Ascenda catheter, introduced in 2011, with the traditional silicone catheter for intrathecal drug infusion. In their analysis, the authors found that the Ascenda catheter can reduce major complications related to the catheter after ITB pump implantation. Further investigation is necessary to expand on and confirm their results.

Authors+Show Affiliations

Department of Paediatric Orthopaedics, "V. Buzzi" Children's Hospital, Milan, Italy.Department of Paediatric Orthopaedics, "V. Buzzi" Children's Hospital, Milan, Italy.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27341610

Citation

Motta, Francesco, and Clara Eleonora Antonello. "Comparison Between an Ascenda and a Silicone Catheter in Intrathecal Baclofen Therapy in Pediatric Patients: Analysis of Complications." Journal of Neurosurgery. Pediatrics, vol. 18, no. 4, 2016, pp. 493-498.
Motta F, Antonello CE. Comparison between an Ascenda and a silicone catheter in intrathecal baclofen therapy in pediatric patients: analysis of complications. J Neurosurg Pediatr. 2016;18(4):493-498.
Motta, F., & Antonello, C. E. (2016). Comparison between an Ascenda and a silicone catheter in intrathecal baclofen therapy in pediatric patients: analysis of complications. Journal of Neurosurgery. Pediatrics, 18(4), 493-498.
Motta F, Antonello CE. Comparison Between an Ascenda and a Silicone Catheter in Intrathecal Baclofen Therapy in Pediatric Patients: Analysis of Complications. J Neurosurg Pediatr. 2016;18(4):493-498. PubMed PMID: 27341610.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison between an Ascenda and a silicone catheter in intrathecal baclofen therapy in pediatric patients: analysis of complications. AU - Motta,Francesco, AU - Antonello,Clara Eleonora, Y1 - 2016/06/24/ PY - 2016/6/25/pubmed PY - 2017/2/17/medline PY - 2016/6/25/entrez KW - Ascenda catheter KW - CP = cerebral palsy KW - CSF = cerebrospinal fluid KW - GMFCS = Gross Motor Function Classification System KW - ITB = intrathecal baclofen therapy KW - PET = polyethylene terephthalate KW - complications KW - functional neurosurgery KW - intrathecal baclofen KW - pediatric patient SP - 493 EP - 498 JF - Journal of neurosurgery. Pediatrics JO - J Neurosurg Pediatr VL - 18 IS - 4 N2 - OBJECTIVE In this single-center study the authors investigated the complications occurring before and after the introduction of the new Ascenda intrathecal catheter (Medtronic Inc.) in pediatric patients treated with intrathecal baclofen therapy (ITB) for spasticity and/or dystonia. METHODS This was a retrospective review of 508 children who had received ITB, 416 with silicone catheters in the 13 years between September 1998 and September 2011 and 92 with Ascenda catheters in the 3 years between September 2011 and August 2014. The authors evaluated major complications such as infections, CSF leaks treated, and problems related to the catheter or pump, and they compared the 2 groups of patients who had received either a silicone catheter or an Ascenda catheter implant. RESULTS One hundred twenty patients in the silicone group (29%) and 1 patient in the Ascenda group (1.1%; p < 0.001) had a major complication. In the silicone group 23 patients (5.5%) were affected by CSF leakage and 75 patients (18%) experienced 82 catheter-related events, such as occlusion, dislodgment, disconnection, or breakage, which required catheter replacement. In the Ascenda group, only 1 patient (1.1%) was affected by CSF leakage. CONCLUSIONS To the authors' knowledge, this study is the first in the literature to compare the performance of the new Ascenda catheter, introduced in 2011, with the traditional silicone catheter for intrathecal drug infusion. In their analysis, the authors found that the Ascenda catheter can reduce major complications related to the catheter after ITB pump implantation. Further investigation is necessary to expand on and confirm their results. SN - 1933-0715 UR - https://www.unboundmedicine.com/medline/citation/27341610/Comparison_between_an_Ascenda_and_a_silicone_catheter_in_intrathecal_baclofen_therapy_in_pediatric_patients:_analysis_of_complications_ L2 - https://thejns.org/doi/10.3171/2016.4.PEDS15646 DB - PRIME DP - Unbound Medicine ER -