Convection enhanced delivery apparatus, method, and application
An embodiment of the invention is directed to a microfabricated, silicon-based, Convection Enhanced Delivery (CED) device. The device comprises a silicon shank portion, at least one individual parylene channel disposed along at least a part of an entire length of the shank, wherein the channel has one or more dimensioned fluid exit ports disposed at one or more respective locations of the channel and a fluid (drug) input opening. The fluid input opening may be configured or adapted to be connected to a fluid reservoir and/or a pump and/or a meter and/or a valve or other suitable control device(s) or apparatus that supplies and/or delivers fluid (e.g., a drug) to the microfabricated device. The device may have multiple channels disposed side by side or in different surfaces of the device. The device may be rigid, or flexible, in which case a flexible device can be attached to a bio-degradable support scaffold that provides sufficient structural rigidity for insertion of the device into the target tissue. In certain “functionalized” embodiments of the invention, the CED device is equipped with integrated electrodes and/or a sensor (e.g., glutamate) to detect and convey selective parametric information. Another embodiment of the invention is directed to a CED method for drugs and/or other agents. The method may comprise the delivery of enzymes or other materials to modify tissue permeability and improve drug diffusion. Another embodiment of the invention is directed to a method for making a device for CED of drugs.
1. A method of delivering a drug to a patient via convection-enhanced delivery, comprising:
providing an implantable convection-enhanced-delivery (CED) device, comprising:
a body having a shank portion at a distal end thereof and a fluid inlet portion that is contiguous with the shank portion;
at least one enclosed channel disposed in at least a portion of a length of the body, wherein the at least one enclosed channel has an inlet port adjacent a proximal end thereof that is adjacent a proximal end of the fluid inlet portion of the body and a distal end disposed in the shank portion,
further wherein the at least one enclosed channel has at least one outlet port along a length of the shank portion;
inserting the device into brain tissue of the patient to form a pathway in the brain tissue;
delivering a fluid containing a first drug under positive pressure through one of said at least one enclosed channel of the device into the brain tissue.
2. The method of claim 1 , wherein delivering the fluid comprises infusing the fluid at a flow rate of 0.1 to 5.0 uL/min.
3. The method of claim 1 , wherein delivering the fluid comprises infusing the fluid into the extracellular matrix of the brain.
4. The method of claim 1 , wherein delivering the fluid comprises infusing the fluid at a constant pressure.
5. The method of claim 1 , wherein the drug comprises AAV vector.
6. The method of claim 1 , further comprising delivering a fluid containing a second drug under positive pressure through a second channel of the device into the brain tissue.
7. The method of claim 6 , wherein the fluid containing the first drug and the fluid containing the second drug are delivered simultaneously.
8. The method of claim 6 , wherein the fluid containing the first drug and the fluid containing the second drug are delivered sequentially.
9. The method of claim 6 , wherein the second drug comprises a hyperosmolar solution.
10. The method of claim 9 , wherein the hyperosmolar solution comprises a mannitol solution.
11. The method of claim 6 , wherein the second drug comprises an enzyme configured to digest an extracellular matrix of the brain.
12. The method of claim 11 , wherein the enzyme comprises hyaluronidase.