title: Local infusion therapy in the monkey brainstem: technical considerations.
abstract: 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.
authors.affiliation: Division of Pediatric Neurological Surgery, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: George I
authors.initials: GI
authors.lastname: Jallo
authors.forename: Marc
authors.initials: M
authors.lastname: Becker
authors.forename: Ya J
authors.initials: YJ
authors.lastname: Liu
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Carson
authors.forename: Michael
authors.initials: M
authors.lastname: Guarnieri
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents