Local infusion therapy in the monkey brainstem: technical considerations.
This chapter assesses the safety of freehand placement of an infusion catheter (outer diameter, 0.3 mm) in brainstems of cynomolgus monkeys (Macaca fascicularis) for local infusion therapy. A posterior midline approach through the cerebellum and roof of the fourth ventricle was used to implant catheters into a pontine target area. Computer tomography (CT), magnetic resonance imaging (MRI), and histology were used to examine the position of the implants. The freehand placement of a catheter resulted in approximately 5-mm variations in anterior-posterior and dorsal-ventral locations of the targeted implantation site. No evidence of morbidity from the surgery, or from the infusion process was present. In conclusion, small-diameter catheters for chronic drug infusions can be implanted safely into the brainstem, an eloquent region that has been considered surgically inoperable. Infusion systems may offer a minimally invasive, generally applicable tool to provide chronic therapy for central nervous system (CNS) lesions.
Jallo
George I
GI
Division of Pediatric Neurological Surgery, Johns Hopkins University, Baltimore, MD, USA.
Becker
Marc
M
Liu
Ya J
YJ
Carson
Benjamin S
BS
Guarnieri
Michael
M
D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D020295:Brain Stem Neoplasms / Q000188:drug therapy*; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods*; D004195:Disease Models, Animal; D036502:Infusions, Intralesional / Q000295:instrumentation* / Q000379:methods*; D008252:Macaca fascicularis; D008297:Male
D000970:Antineoplastic Agents