Systems and methods for drug delivery, treatment, and monitoring
Systems and methods for delivering a drug or other therapy over an extended period of time (e.g., several hours, days, weeks, months, years, and so forth) are disclosed herein, as are systems and methods for monitoring various parameters associated with the treatment of a patient. Systems and methods are also disclosed herein that generally involve CED devices with various features for reducing or preventing backflow.
1. An implantable delivery system, comprising:
a percutaneous access device through which drug-containing fluid can be delivered, the access device including a plurality of ports;
a trunk line having a plurality of independent fluid lumens extending therethrough, the plurality of fluid lumens being in fluid communication with corresponding ones of the plurality of ports formed in the access device;
a manifold comprising a body configured to be secured to a skull of a patient and having an inlet port for the trunk line and a plurality of outlet ports;
a plurality of branch lines connected to the plurality of outlet ports of the manifold, the manifold configured to route the plurality of fluid lumens in the trunk line into the plurality of branch lines, each branch line of the plurality of branch lines including one or more fluid lumens of the plurality of fluid lumens disposed therein;
a skull anchor configured to be secured to the skull of a patient, the skull anchor spaced from the manifold; and
a plurality of microfluidic catheters configured to extend into the brain of a patient, the skull anchor being configured to couple the plurality of branch lines to corresponding ones of the plurality of microfluidic catheters;
wherein at least one of the plurality of microfluidic catheters comprises:
a micro-tip having a proximal portion, a central portion, a distal portion, and at least one fluid channel extending along said proximal, central, and distal portions, the at least one fluid channel having an outlet port at a distal end thereof and an inlet port at a proximal end thereof;
a first outer sheath disposed coaxially over the distal portion of the micro-tip such that the distal portion of the micro-tip protrudes from a distal end of the first outer sheath;
a first tissue-receiving space defined between an exterior surface of the micro-tip and an interior surface of the distal end of the first outer sheath;
a catheter body extending proximally from the micro-tip such that the at least one fluid channel of the micro-tip is in fluid communication with a respective inner lumen of the catheter body; and
a nose portion disposed over at least the central portion of the micro-tip and extending between the first outer sheath and the catheter body such that the nose portion defines an exterior surface that tapers from a reduced distal diameter corresponding to the outside diameter of the first outer sheath to an enlarged proximal diameter corresponding to the outside diameter of the catheter body.
2. The system of claim 1 , further comprising one or more inline filters disposed in the plurality of branch lines; the one or more inline filters configured to remove air, gas, bacteria, or particulates from fluid flowing through the plurality of branch lines.
3. The system of claim 1 , wherein the trunk line, the manifold, the plurality of branch lines, and the skull anchor are configured for long-term implantation beneath the skin of a patient.
4. The system of claim 1 , wherein the percutaneous access device includes one or more electrical connections for coupling extracorporeal electrical conductors to implanted electrical conductors.
5. The system of claim 1 , wherein the trunk line, the manifold, at least one of the plurality of branch lines, the skull anchor, and at least one of the plurality of microfluidic catheters include electrical conductors configured to provide an electrical path between the access device and a sensor or electrode of the at least one of the plurality of microfluidic catheters.
6. The system of claim 1 , wherein the skull anchor is configured to be disposed over first and second burr holes formed in the skull of the patient such that a first catheter of the plurality of microfluidic catheters coupled to the skull anchor extends through the first burr hole and a second catheter of the plurality of microfluidic catheters coupled to the skull anchor extends through the second burr hole.
7. The system of claim 1 , wherein the skull anchor is configured to be disposed over a first burr hole such that first and second catheters of the plurality of microfluidic catheters coupled to the skull anchor extend through the first burr hole.
8. The system of claim 1 , wherein the micro-tip of the at least one of the plurality of microfluidic catheters includes an array of sensors.
9. The system of claim 8 , wherein the array of sensors is printed on a substrate of the micro-tip.
10. The system of claim 8 , wherein the array of sensors is formed on a ribbon affixed to the micro-tip.
11. The system of claim 8 , wherein the array of sensors includes at least one electrode.
12. The system of claim 1 , wherein the at least one of the plurality of microfluidic catheters includes a sensor.
13. The system of claim 12 , wherein the sensor comprises at least one of: an interrogatable sensor, a pressure sensor, a glutamate sensor, a pH sensor, a temperature sensor, an ion concentration sensor, a carbon dioxide sensor, an oxygen sensor, a neurotransmitter sensor, or a lactate sensor.
14. The system of claim 12 , wherein the sensor is disposed in the respective fluid lumen of the catheter body adjacent an outlet port thereof such that fluid flowing through the outlet port washes over the sensor.
15. The system of claim 12 , wherein the catheter body further includes a dedicated patency channel through which fluid can be directed to clean the sensor.
16. The system of claim 12 , wherein the catheter body further includes a dedicated electrical conductor channel through which an electrical conductor coupled to the sensor extends, the electrical conductor channel being separate from the respective fluid lumen.
17. The system of claim 16 , wherein the respective fluid lumen and the electrical conductor channel intersect at a chamber in which the sensor is disposed.
18. The system of claim 1 , wherein the at least one of the plurality of microfluidic catheters includes a biodegradable scaffold on which one or more fluid channels including the respective fluid lumen are formed.
19. The system of claim 18 , wherein the scaffold is configured to biodegrade after being implanted in a patient, leaving behind only the one or more fluid channels.
20. The system of claim 18 , wherein the scaffold extends to a proximal end of the catheter body and is coupled to the skull anchor.
21. The system of claim 18 , wherein the scaffold comprises an upper layer and a lower layer, and wherein the one or more fluid channels are sandwiched between the upper and lower scaffold layers.