WO2001054752A1 - Dispositifs et procedes d'enlevement de liquide cephalo-rachidien d'un espace csf d'un patient - Google Patents

Dispositifs et procedes d'enlevement de liquide cephalo-rachidien d'un espace csf d'un patient Download PDF

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Publication number
WO2001054752A1
WO2001054752A1 PCT/US2000/002367 US0002367W WO0154752A1 WO 2001054752 A1 WO2001054752 A1 WO 2001054752A1 US 0002367 W US0002367 W US 0002367W WO 0154752 A1 WO0154752 A1 WO 0154752A1
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WIPO (PCT)
Prior art keywords
csf
pressure
range
space
minute
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Application number
PCT/US2000/002367
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English (en)
Inventor
Tom A. Saul
Marvin L. Sussman
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Eunoe, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Eunoe, Inc. filed Critical Eunoe, Inc.
Priority to JP2001554735A priority Critical patent/JP2003520647A/ja
Priority to EP00907085A priority patent/EP1253955A4/fr
Priority to PCT/US2000/002367 priority patent/WO2001054752A1/fr
Publication of WO2001054752A1 publication Critical patent/WO2001054752A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
    • A61M27/006—Cerebrospinal drainage; Accessories therefor, e.g. valves

Definitions

  • the present invention relates generally to medical devices and methods. More particularly, the present invention relates to improved devices and methods for removing cerebrospinal fluid (CSF) from the CSF space of. a patient to treat Alzheimer's disease and other diseases.
  • CSF cerebrospinal fluid
  • Alzheimer's disease is a degenerative brain disorder which is characterized clinically by progressive loss of memory, cognition, reasoning, judgment, and emotional stability and which gradually leads to profound mental deterioration and ultimately death.
  • Alzheimer disease is the most common cause of progressive mental failure (dementia) in aged humans and is estimated to represent the fourth most common medical cause of death in the United States .
  • Alzheimer's disease has been observed in all races and ethnic groups worldwide and presents a '1 major current and future public health problem. The disease is currently estimated to affect about two to four million individuals in the United States alone and is presently .considered to be incurable. Recently, a promising treatment for Alzheimer's disease has been proposed.
  • the proposed treatment relies on the removal of cerebrospinal fluid (CSF) from the CSF space (which includes the subarachnoid space, the ventricles, the vertebral column, and the brain interstitial space) of a patient suffering from Alzheimer's disease.
  • CSF cerebrospinal fluid
  • the treatment is based on the principle that in at least some cases, the characteristic lesions, referred to as senile (or amyloid) plaque and other characteristic lesions in the brain associated with Alzheimer's disease result from the retention of certain toxic substances in the CSF of the patient.
  • senile (or amyloid) plaque and other characteristic lesions in the brain associated with Alzheimer's disease result from the retention of certain toxic substances in the CSF of the patient.
  • a number of suspected pathogenic substances, including toxic, neurotoxic, and pathogenic substances have been identified to date, including j3-amyloid peptide (A/3-42 amyloid) , MAP, tau, and the like.
  • Hydrocephalus is another condition which is treated by removing CSF from a patient's CSF space, in particular from the cerebral ventricles. Hydrocephalus is characterized by an elevated intracranial pressure resulting from excessive production or retention of CSF, and the removal of such excess CSF has been found to be a highly effective treatment for the condition. Numerous specific catheters and shunts have been designed and produced for the treatment of hydrocephalus, occult hydrocephalus, and other CSF disorders.
  • the removal of CSF for the treatment of either Alzheimer's disease or hydrocephalus can be accomplished using a wide variety of apparatus which are capable of collecting CSF in the CSF space, preferably from the intracranial ventricles, and transporting the collected fluid to a location outside of the CSF space.
  • the location will be an internal body location, such as the venous system or the peritoneal cavity, which is capable of harmlessly receiving the fluid and any toxic substances, but it is also possible to externally dispose of the CSF using a transcutaneous device.
  • An exemplary system for removing CSF from a patient's CSF space is illustrated in Fig. 1 and includes an access component 12, a disposal component 14, and a flow control component 16.
  • Fig. 1 While the system of Fig. 1 in general will be suitable for the treatment of both Alzheimer's disease and hydrocephalus, specific characteristics of the flow control component should be quite different because of the different nature of the two diseases .
  • Treatment of hydrocephalus is best accomplished by controlling the flow rate of CSF from the CSF space to the disposal location in order to maintain intracranial pressure within normal physiological limits.
  • Particularly suitable flow control characteristics for a flow control module in a hydrocephalus treatment system are illustrated in Fig 2.
  • Fig. 2 is taken from U.S. Patent No. 4,781,672 which describes a flow control valve of the type used in the commercially available Orbis-Sig a ® valve unit available from Nitinol Medical Technologies, Inc. Boston, Massachusetts, 02210 (formerly from Cordis, Miami, Florida) .
  • the pressure P is the differential pressure between the CSF space and the disposal location.
  • the patent teaches that the control valve establishes an initial flow rate Q of about 0.4 ml/min when the differential pressure P reaches an initial level P 1 of 80 mm H 2 0 and increases to a higher flow rate Q 2 of 0.8 ml/min as the differential pressure increases to a higher value P 2 of 350 mm H 2 0.
  • pressure P is below P- L , there is essentially no flow.
  • the flow is essentially unrestricted.
  • Such valve flow characteristic are particularly suitable for treating hydrocephalus because for pressures below P 1 , there is no need to reduce pressure and thus no need to remove CSF .
  • Such devices and methods will preferably provide for the controlled removal of CSF from the patient in a manner which effectively removes the toxic substances to reduced levels without excessive removal of the CSF in a manner which places the patient at risk.
  • Such objective will be met at least in part by the invention described hereinafter.
  • SUMMARY OF THE INVENTION Devices and methods according to the present invention provide for the controlled and optimized removal of cerebrospinal fluid (CSF) from the CSF space of a patient.
  • CSF cerebrospinal fluid
  • the devices and methods are particularly intended for the treatment of Alzheimer's disease and other conditions which are caused by or otherwise related to the retention and accumulation of toxic substances in the CSF.
  • the present invention will be useful for treating other conditions resulting from the accumulation of toxic substances and resulting lesions in the patient's brain, such as Down's Syndrome, hereditary cerebral hemorrhage with amyloidosis of the Dutch-Type (HCHWA-D) , and the like.
  • treatable conditions relating to the chronic or acute presence of potentially putative substances include epilepsy, narcolepsy, Parkinson's disease, polyneuropathies , multiple sclerosis, amyotrophic lateral sclerosis (ALS) , myasthenia gravis, muscular dystrophy, dystrophy myotonic, other myotonic syndromes, polymyositis, dermatomyositis, brain tumors, Guillain-Barre-Syndrome, and the like.
  • Devices and methods of the present invention are intended for treating conditions in patients having "normal" intracranial pressures, i.e. intracranial pressures below 200 mm H 2 0 when the patient is reclining and above -170 mm H 2 0 when the patient is upright (where the pressures are measured relative to the ambient) .
  • patients suffering from hydrocephalus will have constant or periodic elevated intracranial pressures above 200 mm H 2 0 (when reclining) , often attaining levels two or three times the normal level if untreated.
  • the devices and methods of the present invention are not intended for the treatment of patients having elevated intracranial pressures in general and patients suffering from hydrocephalus in particular.
  • treatments and methods according to present invention rely on relatively low CSF removal rates, usually in the range from 0.01 ml/min to 0.2 ml/min, more usually in the range from 0.03 ml/min to 0.1 ml/min, and preferably in the range from 0.04 ml/min to 0.06 ml/min.
  • CSF removal at such low rates will occur continuously or at least so long as the intracranial and ventricular pressures do not fall below certain minimal levels, e.g. below about -170 mm H 2 0.
  • Such safety thresholds correspond generally to the lowest expected ventricular pressure of the patient when upright.
  • the intracranial and ventricular pressures referred to above are defined or measured as "gauge" pressures, i.e. relative to ambient .
  • the intracranial pressure falls below ambient (0 mmH 2 0) as a result of the compliant nature of the CSF space and the column of CSF fluid which is created as the patient sits upright or stands.
  • the ability of the flow control module to maintain a relatively constant flow (as defined below) regardless of the variations in the intracranial or ventricular "source” pressure is an important aspect of the present invention.
  • the CSF removal techniques of the present invention generally rely on pressure-compensated removal to achieve the desired constant flow rate, where the generally constant (usually varying by no more than ⁇ 75%, preferably no more than ⁇ 50%, and more preferably ⁇ 20%) removal rate is achieved by providing a pressure-controlled variable resistance path in the flow control module between the CSF space and the disposal site.
  • the flow control valves for hydrocephalus treatment such as those described in U.S. Patent No. 4,781,672, intentionally provide for significant variation in flow rate as the pressure differential across the flow valve passes through specific control points .
  • Use by the present invention of a generally constant flow rate which is below the normal CSF production rate minimizes the possibility of over removal of the CSF and the risk of occlusion associated with ' CSF stagnation.
  • methods for reducing the concentrations of toxic substances in CSF comprise establishing a drain path from a CSF space in the patient, typically a ventricle in the brain.
  • the drain path is configured or defined to remove CSF at a rate in the ranges set forth above while the intracranial pressure may vary over a relatively broad range, typically from -170 mm H 2 0 to 200 mm H 2 0, depending on patient orientation.
  • the CSF flow rate will vary by no more than ⁇ 75%, usually ⁇ 50%, and preferably ⁇ 20%, as the intracranial pressure varies over the above range .
  • the drain path may extend to any internal or external disposal location of a type commonly used with the treatment of hydrocephalus.
  • the disposal location will be 'into the venous system, the peritoneal cavity (peritoneal space) , the pleural cavity (pleural space) , or the like. It will also be possible (although usually less desirable) to employ transcutaneous devices where disposal occurs to an external space outside of the patient ' s body, e.g. into a drainage bag.
  • Apparatus according to present invention comprise access component, such as a catheter adapted to reside in the ventricle or other portion of the CSF space of the patient, (e.g., a lumbar space) and a flow control component connectable to an outlet of the access component.
  • the flow control component will be adapted to control the CSF flow rate from the access component within the flow rate ranges set forth above, while the pressure in the CSF space varies over the range set forth above.
  • the flow control component will be passive, i.e. a pressure- compensated flow control valve.
  • the present invention also includes actively controlled flow control valves and pumps , where the valves and pumps can be powered by battery, patient movement, or the like.
  • the .apparatus may further comprise a disposal component connectable to an outlet of the flow control component .
  • the disposal component will usually be adapted to further direct the drain path to a target disposal site, such as the venous system, peritoneal cavity, pleural cavity, or the like.
  • the flow control component will further be adapted to stop or greatly reduce the flow of CSF when intracranial pressure falls below the safety threshold set forth above .
  • the apparatus may comprise the flow control module alone .
  • the flow control module comprises a diaphragm valve connectable to an outlet of an access component.
  • the diaphragm valve includes a pressure-responsive diaphragm, a contoured plug, and an orifice which receives the contoured plug and permits the flow of CSF therethrough. Either the plug or the orifice is coupled to move with the diaphragm in response to changes in the differential pressure across the valve.
  • the contoured plug has a profile (or other modification) which is selected to provide a variable annular flow region between the plug and the orifice so that flow is controlled within the target range as set forth above while the intracranial pressure varies within the range set forth above.
  • the orifice will be directly coupled to the diaphragm, while the plug is fixed relative to a valve body.
  • the apparatus may further comprise an access component and/or a disposal component, which may be any of the components described above .
  • Fig. 1 is a schematic illustration showing the components and placement of a conventional system for removing cerebrospinal fluid from a CSF space of the brain.
  • Fig. 2 illustrates the pressured-flow relationship of a conventional flow valve used in systems such as those shown in Fig. 1 for treating hydrocephalus.
  • Fig. 3 illustrates exemplary flow-pressure relationships for the devices and methods of the present invention.
  • Fig. 4 is a schematic illustration of apparatus according to the present invention for draining CSF from a CSF space of the patient's brain in accordance with the principles of the present invention.
  • Figs. 5A-5C illustrates modifications that can be made to the flow control valve of U.S. Patent No. 4,781 ⁇ 672, so that the valve described in that patent will display flow-pressure characteristics in accordance with the principles of the present invention.
  • Figs. 6A and 6B illustrate an alternative embodiment of a valve mechanism for practicing the present invention.
  • the brain and spinal cord are bathed in cerebrospinal fluid (CSF) and encased within the cranium and vertebral column inside a thin membrane known as the meninges (Fig. 1A) .
  • the space within the meninges includes the subarachnoid space SAS, the ventricles (including the lateral ventricle LV, third ventricle 3V, and fourth ventricle 4V) , the vertebral column, and the brain interstitial spaces, and is referred to herein as the "CSF space.”
  • the volume of the brain intracranial spaces is on average about 1700 ml.
  • the volume of the brain is approximately 1400 ml, and the volume of the intracranial blood is approximately 150 ml.
  • the remaining 150 ml is filled with CSF (this volume may vary within 60 ml to 290 ml) .
  • the CSF circulates within the CSF space.
  • CSF is formed principally by the choroid plexuses, which secrete about 80% of the total volume of the CSF.
  • the sources of the remainder are the vasculature of the subependymal regions, and the pia matter.
  • the total volume of the CSF is renewed several times per day, so that about 500 ml are produced every 24 hours (equivalent to about 20 l/hr or 0.35 ml/min) in healthy adults.
  • the production rate varies in the old and the young .
  • the cerebrospinal -fluid is absorbed through the arachnoid villi, located principally over the superior surfaces of the cerebral hemispheres. Some villi also exist at the base of the brain and along the roots of the spinal nerves.
  • the absorptive processes include bulk transport of large molecules and as well as diffusion across porous membranes of small molecules. The production and absorption of CSF are well described in the medical literature. See, e.g., Adams et al . (1989) "Principles of Neurology," pp. 501-502.
  • the present invention is directed at particular devices and methods for the improved removal of such substances from the CSF in order to treat, inhibit, or ameliorate conditions associated with such toxic materials.
  • the present invention is directed at reducing the concentration of such substances in CSF by removing portions of the CSF from the CSF space.
  • Such removal is believed to either enhance production of the CSF and/or reduce the natural absorption of the CSF so that the total volume of CSF in " the CSF space is not reduced below a safe level.
  • the rates at which the CSF is removed are generally quite low (when compared to the rates of removal for treatment of the hydrocephalus) so that the likelihood of removing excessive amounts of CSF is very low.
  • the toxic substances present in the removed CSF will thus be removed from the CSF space and will not be available for absorption or recirculation. So long as the rate of removal exceeds the rate of production of such substances, the concentration of such substances can be reduced.
  • the removed CSF will be directed to a natural disposal site within the patient ' s body which can tolerate the toxic substance. Suitable sites, particularly for those substances associated with Alzheimer's disease as discussed above, include the venous system, peritoneal cavity, the pleural cavity, and the like.
  • a toxic substance would be deleterious if transferred within the patient's body, or for any other reason, it is also possible to remove the CSF from the patient's body, e.g. using a transcutaneous catheter and external collection bag or other receptacle. It will generally be preferable to maintain the entire system subcutaneously for patient convenience and to reduce the risk of infection.
  • the devices and methods of present inventions are particularly intended to maintain a relatively constant flow rate F of CSF from the CSF space at normal intracranial pressures P (e.g. -170 mm H 2 0 to 200 mm H 2 0 relative to ambient) .
  • P normal intracranial pressure
  • the devices and methods will be configured to remove little or no CSF at intracranial pressures below a threshold value P 0 which is at or near the lowest expected intracranial pressure for an upright patient, typically -170 mm of H 2 0.
  • the CSF flow rate F will usually be between a lower values F- j _ and an upper value F 2 , with particular ranges set forth above.
  • the flow rate F will be at a relatively constant level, with the rate preferably being pressure-corrected so that it does not vary by more than ⁇ 75%, preferably by no more than ⁇ 50%, and more preferably by no more than ⁇ 20% for intracranial pressures within the expected ranges.
  • the flow rate F be constant at least over the range P 0 to P x , and more preferable that the flow rate remains constant for even higher differential pressures since the present invention is not intended to treat excessive intracranial pressure, but rather to remove the CSF at a relatively low, constant rate regardless of the differential pressure (so long as P is above the threshold P 0 ) .
  • Apparatus according to the present invention for removing CSF from a CSF space is illustrated schematically in Fig 4.
  • Apparatus will generally include an access component 50, a flow rate control component 60, optionally a disposal component 70, and optionally a flow or detection component 80.
  • present invention may use components of a type described in co-pending application Serial No. 08/901,023, the full disclosure which has previously been incorporated herein by reference.
  • the flow rate control component 60 will be constructed specifically to achieve the flow-pressure response characteristics which have been discussed previously.
  • a passive flow control valve of the type illustrated in U.S. Patent No. 4,781,672 may be modified to provide the flow-pressure characteristics of the present invention.
  • the full disclosure of U.S. Patent No. 4,781,672 is incorporated herein by reference.
  • the flow characteristic of the present invention may be achieved.
  • valve seat 67' and valve stem 68' as illustrated in Figs. 5A-5C the desired flow characteristics can be achieved.
  • the valve seat 67' and valve stem 68' comprise an orifice and contoured valve plug according to the claims in the present application.
  • a notched, sliced or tapered surface 69 maybe formed on one side of the valve plug 68' to change the available annular area between the plug and the seat 67 ' as the plug is raised relative to the seat, as shown in Figs. 5B and 5C.
  • an annular ring 65 formed on the lower surface of a stationary component 66 seats against an upper surface of the valve seat 67'.
  • the valve is closed.
  • CSF flows into the valve structure, it exerts pressure against the valve seat 67 ' , which is mounted in a diaphragm causing the valve seat to move lower as shown in both Figs. 5B and 5C.
  • valve seat 67' With a relatively low differential pressure, the valve seat 67' lowers partly down the valve plug 68 ' , entering into or further a portion of the notched region 69 which expands the annular space between the plug 68' and the valve seat 67' . As the inlet pressure further increases (and thus the differential pressure also increases), the valve seat 67' moves further down, moving to a portion of the notch where the available flow area through the valve seat 67' is reduced.
  • the valve structure is pressure-compensated so that the resistance to flow increases as the differential pressure increases, which acts to maintain a constant flow rate regardless of the system differential pressure.
  • the total travel of the valve from Fig 5A-5C will generally be selected to occur so that the valve first opens at a differential pressure of approximately P 0 and fully opens at a differential pressure which is well above the maximum expected differential pressure P, so that relatively constant flow rates may be maintained over the entire expected differential pressure range P 0 to P ⁇ .
  • the values P of differential pressure are the sum of the intracranial pressure, hydrostatic pressure, and pressure at the release site, e.g. intra- abdominal pressure.
  • a valve structure 100 comprises a plate 102 having an inlet orifice 104.
  • a reciprocating valve plug 106 is attached to the plate 108 on its upper end.
  • the plate seats against a sealing ring 110 projecting downwardly from the plate 102 so that the valve is closed until a sufficient CSF inlet pressure develops across orifice 104 to open valve plug 106 against a spring 112 which is under slight compression.
  • CSF will flow past the plate 108 and into the annular space 120 between the plug 106 and a cylindrical wall 122 formed in the valve body.
  • the plug 20 will be further lowered, thus increasing the length of the annular lumen which is formed between the plug 106 and the cylindrical wall 122.
  • the resistance to flow also increases, thus making the valve structure 100 a pressure-compensating structure in accordance with the principles of the present invention. That is, as the differential pressure across the plug 106 increases, the plug will be displaced further into the cylindrical space 122. A force balance will be reached when the upward force of spring 112 becomes equal the downward force on the plug 106 by the differential pressure across the plug. The valve plug will thus move downward to increase flow resistance in response to increased differential pressures.

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  • Heart & Thoracic Surgery (AREA)
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Abstract

L'invention concerne des dispositifs et des procédés permettant l'enlèvement de liquide céphalo-rachidien (CSF) d'un espace CSF d'un patient à des débits relativement constants, pour des patients ayant des pressions intracrâniennes normales, c'est-à-dire ne souffrant pas d'hydrocéphalie. Les dispositifs et les procédés fournissent des trajets de drainage permettant l'enlèvement de CSF à des débits relativement faibles, habituellement inférieurs à 0,2 ml/min, sous des pressions intracrâniennes normales, par exemple, une pression intracrânienne comprise entre -170 mm de H20 chez des patients en station debout, et de 200 mm de H20 chez des patients couchés. L'enlèvement de CSF à des débits constants, relativement faibles, est particulièrement approprié pour le traitement de maladies d'Alzheimer et autres états en relation avec la présence de substances toxiques et/ou pathogènes dans le CSF.
PCT/US2000/002367 2000-01-27 2000-01-27 Dispositifs et procedes d'enlevement de liquide cephalo-rachidien d'un espace csf d'un patient WO2001054752A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
JP2001554735A JP2003520647A (ja) 2000-01-27 2000-01-27 患者の脳脊髄液（ｃｓｆ）腔から脳脊髄液を除去するための装置および方法
EP00907085A EP1253955A4 (fr) 2000-01-27 2000-01-27 Dispositifs et procedes d'enlevement de liquide cephalo-rachidien d'un espace csf d'un patient
PCT/US2000/002367 WO2001054752A1 (fr) 2000-01-27 2000-01-27 Dispositifs et procedes d'enlevement de liquide cephalo-rachidien d'un espace csf d'un patient

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2000/002367 WO2001054752A1 (fr) 2000-01-27 2000-01-27 Dispositifs et procedes d'enlevement de liquide cephalo-rachidien d'un espace csf d'un patient

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WO2001054752A1 true WO2001054752A1 (fr) 2001-08-02

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WO (1) WO2001054752A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6905474B2 (en) 2000-09-11 2005-06-14 Csf Dynamic A/S Fluid shunt system and a method for the treatment of hydrocephalus
WO2007085771A2 (fr) * 2006-01-26 2007-08-02 Sophysa Systeme de drainage pour le traitement de l'hydrocephalie

Citations (10)

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Publication number Priority date Publication date Assignee Title
US3889687A (en) 1974-01-31 1975-06-17 Donald L Harris Shunt system for the transport of cerebrospinal fluid
US3913587A (en) 1973-12-10 1975-10-21 Dow Corning Implantable extendable member
US3985140A (en) 1975-06-30 1976-10-12 Cordis Corporation Dual pressure valve for use in ventricular shunt system
US4375816A (en) 1979-10-17 1983-03-08 Michele Labianca Catheters for shunting systems for the treatment of hydrocephalus
US4377169A (en) 1981-06-10 1983-03-22 Banks Bruce A Ion beam sputter-etched ventricular catheter for hydrocephalus shunt
US4385636A (en) 1978-05-23 1983-05-31 Cosman Eric R Telemetric differential pressure sensor with the improvement of a conductive shorted loop tuning element and a resonant circuit
US4781672A (en) 1986-10-21 1988-11-01 Cordis Corporation Three stage implantable flow control valve with improved valve closure member
WO1998002202A1 (fr) 1996-07-11 1998-01-22 Csfluids, Inc. Procede et appareil de traitement de la demence de l'adulte du type alzheimer
US5728061A (en) * 1988-10-07 1998-03-17 Ahmed; Abdul Mateen Device and method for treating hydrocephalus
US5830172A (en) * 1991-04-11 1998-11-03 Leveen; Harry H. Ascites valve

Patent Citations (11)

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Publication number Priority date Publication date Assignee Title
US3913587A (en) 1973-12-10 1975-10-21 Dow Corning Implantable extendable member
US3889687A (en) 1974-01-31 1975-06-17 Donald L Harris Shunt system for the transport of cerebrospinal fluid
US3985140A (en) 1975-06-30 1976-10-12 Cordis Corporation Dual pressure valve for use in ventricular shunt system
US4385636A (en) 1978-05-23 1983-05-31 Cosman Eric R Telemetric differential pressure sensor with the improvement of a conductive shorted loop tuning element and a resonant circuit
US4375816A (en) 1979-10-17 1983-03-08 Michele Labianca Catheters for shunting systems for the treatment of hydrocephalus
US4377169A (en) 1981-06-10 1983-03-22 Banks Bruce A Ion beam sputter-etched ventricular catheter for hydrocephalus shunt
US4781672A (en) 1986-10-21 1988-11-01 Cordis Corporation Three stage implantable flow control valve with improved valve closure member
US5728061A (en) * 1988-10-07 1998-03-17 Ahmed; Abdul Mateen Device and method for treating hydrocephalus
US5830172A (en) * 1991-04-11 1998-11-03 Leveen; Harry H. Ascites valve
WO1998002202A1 (fr) 1996-07-11 1998-01-22 Csfluids, Inc. Procede et appareil de traitement de la demence de l'adulte du type alzheimer
US5980480A (en) * 1996-07-11 1999-11-09 Cs Fluids, Inc. Method and apparatus for treating adult-onset dementia of the alzheimer's type

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Title
See also references of EP1253955A4 *

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6905474B2 (en) 2000-09-11 2005-06-14 Csf Dynamic A/S Fluid shunt system and a method for the treatment of hydrocephalus
WO2007085771A2 (fr) * 2006-01-26 2007-08-02 Sophysa Systeme de drainage pour le traitement de l'hydrocephalie
WO2007085771A3 (fr) * 2006-01-26 2007-12-06 Sophysa Sa Systeme de drainage pour le traitement de l'hydrocephalie
US8177737B2 (en) 2006-01-26 2012-05-15 Sophysa Drainage system for treating hydrocephalus

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EP1253955A1 (fr) 2002-11-06
JP2003520647A (ja) 2003-07-08
EP1253955A4 (fr) 2006-07-19

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