title: Neurosurgical Techniques for Disruption of the Blood-Brain Barrier for Glioblastoma Treatment.
abstract: The blood-brain barrier remains a main hurdle to drug delivery to the brain. The prognosis of glioblastoma remains grim despite current multimodal medical management. We review neurosurgical technologies that disrupt the blood-brain barrier (BBB). We will review superselective intra-arterial mannitol infusion, focused ultrasound, laser interstitial thermotherapy, and non-thermal irreversible electroporation (NTIRE). These technologies can lead to transient BBB and blood-brain tumor barrier disruption and allow for the potential of more effective local drug delivery. Animal studies and preliminary clinical trials show promise for achieving this goal.
authors.affiliation: The Brain Tumor Center of Excellence, Department of Neurosurgery, Wake Forest University, Medical Center Boulevard, Winston Salem 27157, NC, USA. arodrigu@wakehealth.edu.
authors.forename: Analiz
authors.initials: A
authors.lastname: Rodriguez
authors.affiliation: The Brain Tumor Center of Excellence, Department of Neurosurgery, Wake Forest University, Medical Center Boulevard, Winston Salem 27157, NC, USA. statter@wakehealth.edu.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Tatter
authors.affiliation: The Brain Tumor Center of Excellence, Department of Neurosurgery, Wake Forest University, Medical Center Boulevard, Winston Salem 27157, NC, USA. debinski@wakehealth.edu.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Debinski
keywords: blood–brain barrier; focused ultrasound; glioblastoma; intra-arterial drug delivery; laser interstitial thermotherapy; non-thermal irreversible electroporation