VIEshunt: towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapy
Abstract Background Shunt systems for hydrocephalus therapy are commonly based on passive mechanical pressure valves that are driven by the intracranial, intra-abdominal, and hydrostatic pressure. The differential pressure acting on the valve determines the drainage rate of cerebrospinal fluid (CSF)...
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BMC
2025-03-01
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| Series: | Fluids and Barriers of the CNS |
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| Online Access: | https://doi.org/10.1186/s12987-025-00629-w |
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| author | Fabian Flürenbrock Leonie Korn Dominik Schulte Anthony Podgoršak Joris Chomarat Janina Hug Tiago Hungerland Caroline Holzer David Iselin Luca Krebs Rosina Weiss Markus F. Oertel Lennart Stieglitz Miriam Weisskopf Mirko Meboldt Melanie N. Zeilinger Marianne Schmid Daners |
| author_facet | Fabian Flürenbrock Leonie Korn Dominik Schulte Anthony Podgoršak Joris Chomarat Janina Hug Tiago Hungerland Caroline Holzer David Iselin Luca Krebs Rosina Weiss Markus F. Oertel Lennart Stieglitz Miriam Weisskopf Mirko Meboldt Melanie N. Zeilinger Marianne Schmid Daners |
| author_sort | Fabian Flürenbrock |
| collection | DOAJ |
| description | Abstract Background Shunt systems for hydrocephalus therapy are commonly based on passive mechanical pressure valves that are driven by the intracranial, intra-abdominal, and hydrostatic pressure. The differential pressure acting on the valve determines the drainage rate of cerebrospinal fluid (CSF) but is not a gauge of the physiological condition of the patient. Internal and external influences can cause over- or underdrainage and lead to pathological levels of intracranial pressure (ICP). Methods The first prototype of a ventricular intelligent and electromechanical shunt (VIEshunt) is developed, tested, and compared with previous efforts towards the development of a smart shunt. Its key components are a micro pump, a flow meter, a pressure sensor, an inertial measurement unit, a wireless communication interface, and a microcontroller. The VIEshunt prototype was tested in vitro using a hardware-in-the-loop (HiL) test bench that runs real-time patient simulations involving changes in intracranial and intra-abdominal pressure, as well as changes in posture ranging between supine and upright position. The prototype was subsequently tested in an in vivo pilot study based on an acute ovine animal model (n=1) with infusions of artificial CSF. Results During 24 h in vitro testing, the prototype detected the simulated posture changes of the patient and automatically adapted the controller reference. The posture-specific ICP references of 12 mmHg for supine and —3 mmHg for upright position were tracked without offset, thus preventing adverse over- and underdrainage during the investigated HiL test scenario. During acute in vivo testing, the prototype first regulated the mean ICP of a sheep from 22 mmHg down to 20 mmHg. Each of the three subsequent intraventricular bolus infusions of 1 mL saline solution increased mean ICP by approximately 11 mmHg. While natural absorption alone decreased ICP by only 5 mmHg within 9 min, the prototype was able to regulate ICP back to the pre-bolus pressure value within 5 min. Conclusion The developed VIEshunt prototype is capable of posture-dependent ICP regulation and CSF drainage control. Smart shunt systems based on VIEshunt could improve patient monitoring and enable optimal physiologic therapy by adapting to the individual patient. To derive statistically relevant conclusions for the performance of VIEshunt, future work will focus on the development of a next generation prototype for use in pre-clinical studies. |
| format | Article |
| id | doaj-art-c3a2f9c1a5ad457f877c62b4b9af790d |
| institution | DOAJ |
| issn | 2045-8118 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | Fluids and Barriers of the CNS |
| spelling | doaj-art-c3a2f9c1a5ad457f877c62b4b9af790d2025-08-20T03:02:19ZengBMCFluids and Barriers of the CNS2045-81182025-03-0122111510.1186/s12987-025-00629-wVIEshunt: towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapyFabian Flürenbrock0Leonie Korn1Dominik Schulte2Anthony Podgoršak3Joris Chomarat4Janina Hug5Tiago Hungerland6Caroline Holzer7David Iselin8Luca Krebs9Rosina Weiss10Markus F. Oertel11Lennart Stieglitz12Miriam Weisskopf13Mirko Meboldt14Melanie N. Zeilinger15Marianne Schmid Daners16Institute for Dynamic Systems and Control, ETH ZurichInstitute for Dynamic Systems and Control, ETH ZurichInstitute for Dynamic Systems and Control, ETH ZurichProduct Development Group Zurich, ETH ZurichProduct Development Group Zurich, ETH ZurichProduct Development Group Zurich, ETH ZurichProduct Development Group Zurich, ETH ZurichProduct Development Group Zurich, ETH ZurichProduct Development Group Zurich, ETH ZurichProduct Development Group Zurich, ETH ZurichProduct Development Group Zurich, ETH ZurichDepartment of Neurosurgery, University Hospital ZurichDepartment of Neurosurgery, University Hospital ZurichCenter for Preclinical Development, University Hospital Zurich and University of ZurichProduct Development Group Zurich, ETH ZurichInstitute for Dynamic Systems and Control, ETH ZurichInstitute for Dynamic Systems and Control, ETH ZurichAbstract Background Shunt systems for hydrocephalus therapy are commonly based on passive mechanical pressure valves that are driven by the intracranial, intra-abdominal, and hydrostatic pressure. The differential pressure acting on the valve determines the drainage rate of cerebrospinal fluid (CSF) but is not a gauge of the physiological condition of the patient. Internal and external influences can cause over- or underdrainage and lead to pathological levels of intracranial pressure (ICP). Methods The first prototype of a ventricular intelligent and electromechanical shunt (VIEshunt) is developed, tested, and compared with previous efforts towards the development of a smart shunt. Its key components are a micro pump, a flow meter, a pressure sensor, an inertial measurement unit, a wireless communication interface, and a microcontroller. The VIEshunt prototype was tested in vitro using a hardware-in-the-loop (HiL) test bench that runs real-time patient simulations involving changes in intracranial and intra-abdominal pressure, as well as changes in posture ranging between supine and upright position. The prototype was subsequently tested in an in vivo pilot study based on an acute ovine animal model (n=1) with infusions of artificial CSF. Results During 24 h in vitro testing, the prototype detected the simulated posture changes of the patient and automatically adapted the controller reference. The posture-specific ICP references of 12 mmHg for supine and —3 mmHg for upright position were tracked without offset, thus preventing adverse over- and underdrainage during the investigated HiL test scenario. During acute in vivo testing, the prototype first regulated the mean ICP of a sheep from 22 mmHg down to 20 mmHg. Each of the three subsequent intraventricular bolus infusions of 1 mL saline solution increased mean ICP by approximately 11 mmHg. While natural absorption alone decreased ICP by only 5 mmHg within 9 min, the prototype was able to regulate ICP back to the pre-bolus pressure value within 5 min. Conclusion The developed VIEshunt prototype is capable of posture-dependent ICP regulation and CSF drainage control. Smart shunt systems based on VIEshunt could improve patient monitoring and enable optimal physiologic therapy by adapting to the individual patient. To derive statistically relevant conclusions for the performance of VIEshunt, future work will focus on the development of a next generation prototype for use in pre-clinical studies.https://doi.org/10.1186/s12987-025-00629-wHydrocephalusSmart shuntIntracranial pressureCerebrospinal fluidPatient posturePressure and drainage control |
| spellingShingle | Fabian Flürenbrock Leonie Korn Dominik Schulte Anthony Podgoršak Joris Chomarat Janina Hug Tiago Hungerland Caroline Holzer David Iselin Luca Krebs Rosina Weiss Markus F. Oertel Lennart Stieglitz Miriam Weisskopf Mirko Meboldt Melanie N. Zeilinger Marianne Schmid Daners VIEshunt: towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapy Fluids and Barriers of the CNS Hydrocephalus Smart shunt Intracranial pressure Cerebrospinal fluid Patient posture Pressure and drainage control |
| title | VIEshunt: towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapy |
| title_full | VIEshunt: towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapy |
| title_fullStr | VIEshunt: towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapy |
| title_full_unstemmed | VIEshunt: towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapy |
| title_short | VIEshunt: towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapy |
| title_sort | vieshunt towards a ventricular intelligent and electromechanical shunt for hydrocephalus therapy |
| topic | Hydrocephalus Smart shunt Intracranial pressure Cerebrospinal fluid Patient posture Pressure and drainage control |
| url | https://doi.org/10.1186/s12987-025-00629-w |
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