Pre-Sure

Principal Investigator: Sunghoon Kim, MD
Team Members: Sunghoon Kim, MD, Young Lee, MD, Yu-Chong Tai, PhD, Kuang Ming, Kurtis Auguste, MD, Olajire Idowu, MD, James Ferguson DVM

Challenge

Hydrocephalus is a common neurological disease characterized by accumulation of cerebrospinal fluid in the brain usually due to blockage of drainage pathways which can lead to increased intracranial pressure as well as neurologic and cognitive deficits. The current standard treatment for hydrocephalus is the surgical placement of a shunt catheter that drains the cerebrospinal fluid from its source in the cerebral ventricles into other body cavities such as the abdomen or atrium of the heart. There is an extraordinarily high failure rate (30-50% in first year, >50% in second year) of the treatments to shunt CSF which includes ventriculoperitoneal shunting as the main procedure. Ventriculoperitoneal shunt surgery is the most common procedure for hydrocephalus. At least 1 ventriculoperitoneal shunt complication occurs in 23.8% of patients and the revision rate is 22% as a result. Over the long term (10 years), 98% of shunts have failed at least once. The most common reason for shunt failure is obstruction with 60% occurring at proximal catheter, 30% at the valve, and the remainder distally. These failures could be distinguished by pressure measurements along the shunt.

Solution

A device that is non-invasive, wireless, battery-less, implanted, MRI compatible, and biologically inert has been developed by a Caltech team led by YC Tai, PhD, Professor of Bioengineering and Kuang Ming, graduate student in conjunction with a UCSF team led by Sunghoon Kim, MD, Professor of Pediatric Surgery, Young Lee, MD, neurosurgery resident, Kurtis Auguste, MD, Professor of Pediatric Neurosurgery, and Peter Sun, MD, Professor of Pediatric Neurosurgery to address this issue. It is a unique device that is miniaturized to fit within shunt tubing to detect pressures along the shunt to detect aberrations in pressure indicative of shunt failure. This allows the non-invasive measurement of intraventricular and distal ventriculoperitoneal shunt pressure as a critical step in the diagnosis of shunt failure. It is currently working in the early prototype phase and has received significant philanthropic funding for development and pre-clinical studies.