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Results for “Infusion Pumps, Implantable”

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At least 19 recordsLinked to original sources
PubMed1995

Complications associated with infusion pumps implanted for spasticity.

Implanted infusion pumps are an effective method for delivering medications into the intrathecal space to reduce spasticity. Complications can occur with the surgical aspect of implantation, as well as with the hardware. We describe an 8-year experience with the implantation of 34 infusion pumps in 30 patients in whom either morphine or baclofen was used to control spasticity. The overall incidence of total complications was 62%; 24% in the Infusaid pumps, and 167% in the Medtronic pumps. The incidence and types of complications are important in informed consent as well as in the selection of pumps and connectors.

Adult↗
PubMed1985

Modification of the catheterization procedure for the totally implantable infusion pump.

The totally implantable infusion pump is a new and expensive device. Once this pump is unpacked and is in contact with a patient, it is impossible to have it resterilized. For this reason, we suggest the use of a separate catheter for catheterization. Once the catheter is successfully placed in the appropriate artery, then the pump can be unpacked and attached to this catheter. If catheterization proves impossible, the pump is still sterile and can be used for the next patient.

Catheterization↗
PubMed1997

Continuous intrathecal meperidine via an implantable infusion pump for chronic, nonmalignant pain.

OBJECTIVE: To report a continuous infusion of intrathecal meperidine via an implanted infusion pump for nonmalignant, chronic pain. CASE SUMMARY: A 69-year-old white woman had chronic, nonmalignant low-back pain and bilateral leg pain. Multiple drug therapies and other interventional techniques had failed. The patient achieved significant pain relief by a continuous infusion of intrathecal meperidine via an implanted infusion pump. DISCUSSION: To our knowledge, this is the first report of meperidine administered intrathecally by continuous infusion. Continuous infusion of intrathecal and epidural opiates by implanted infusion pumps is becoming more widely recognized as an alternative treatment for patients with chronic, benign pain. Epidural and intrathecal meperidine is an effective analgesic for short-term surgical procedures. Data reporting effective relief and safety with continuous intrathecal meperidine remain limited. CONCLUSIONS: Continuous intrathecal meperidine via an implantable infusion pump may be an effective alternative in the treatment of chronic pain.

Aged↗
PubMed1990

[Therapeutic effects by implantable infusion pump for hepatic malignant tumors].

Chemotherapy and chemoembolization using implantable infusion pump were performed in fifteen cases of hepatocellular carcinoma (HCC) and one case of cholangioma. The following results were obtained; (1) Complete response (CR) was obtained in two cases (12.5%) and partial response (PR) in three cases (18.8%) with HCC. (2) Tumor thrombus in the portal vein disappeared in two of four cases with HCC. (3) The followup period ranged from 54 to 768 days and administration from one to 33 times. These results suggest that good therapeutic effects and quality of life can be obtained by implantable drug delivery system.

Adult↗
PubMed2005

Intrathecal drug therapy using the Codman Model 3000 Constant Flow Implantable Infusion Pumps: experience with 17 cases.

OBJECTIVES: The objective of this study was to evaluate the accuracy, reliability, safety, and efficacy of the Codman Model 3000 Constant Flow Implantable Infusion Pump for intrathecal baclofen delivery as a therapeutic option for the treatment of severe spasticity. The distinctive features of this pump include a raised, easily palpable septum, a safety valve protecting the bolus pathway, no programmer needed, and no battery to fail. DESIGN: A total of 17 patients with spinal cord injury, multiple sclerosis, or cerebral palsy were implanted with this pump. The accuracy of the pump and drug treatment efficacy was determined at each visit and adjustments to the dosages were made as required. All the intrathecal drug delivery system complications were reviewed. RESULTS: The expected efficacy was achieved. The accuracy of the implanted pumps ranged from 90-97% (average 94%). There were no complications due to primary pump problems. The complications reported are similar to other implantable infusion devices and include dehiscence of the suture line, pressure ulcer development, formation of seroma, inversion of the pump, baclofen overdose, and catheter failures. CONCLUSION: The Codman Model 3000 Constant Flow Implantable Infusion Pump is an accurate, reliable, and convenient option for patients needing intrathecal baclofen therapy, with complications similar to other available pumps.

Adolescent↗
PubMed1983

[Completely implantable infusion pump. A new therapeutic possibility for selected patients with liver tumors].

The action of floxuridine depends greatly on its concentration for treatment of liver metastases of colorectal carcinomas and other tumors. In isolated liver metastases it is best infused regionally in order to achieve a high concentration and to reduce systemic toxicity, particularly as it is almost entirely extracted by the liver. A totally implantable infusion pump has established itself as an effective, safe and reliable device of regional chemotherapy with floxuridine for palliative treatment of selected patients with metastases of colorectal carcinomas and other tumors. Life expectancy of patients with metastases of colorectal carcinomas was prolonged by 12-18 months when compared to a precedent control group without regional chemotherapy. This results require confirmation in a randomised phase III study. Patients with hepatocellular carcinoma can be treated with intraarterial doxorubicine and floxuridine infusions. Preliminary results are encouraging. The implantable system represents a major advance in drug administration, not only for the treatment of malignant disease but also a large number of other diseases. Continuous infusion of drugs using an implantable pump system will probably achieve greater importance in the future in the treatment of cancer.

Carcinoma, Hepatocellular↗
PubMed1985

Outpatient dobutamine infusion using a totally implantable infusion pump for refractory congestive heart failure.

A patient with refractory congestive heart failure was treated, on an outpatient basis, with intermittent dobutamine using a totally implantable infusion pump. Dobutamine was infused for 48 hours every week and resulted in sustained clinical improvement. Symptoms and signs of congestive heart failure remained well controlled until his death from a stroke eight months after implantation of the pump.

Aged↗
PubMed1987

Intra-arterial chemotherapy for head and neck cancer. An update on the totally implantable infusion pump.

Intra-arterial chemotherapy for the treatment of localized malignant neoplasms in the head and neck is an appealing approach for several reasons. Perhaps the most important is the possibility of obtaining a regional advantage such that an increased drug concentration is delivered systemically. The patient may, therefore, be spared systemic toxicity. We report our accumulated experience using a totally implantable infusion pump in 37 patients. A total of 42 pumps were implanted: 28 single-catheter pumps and 14 dual-catheter pumps. Radionuclide imaging demonstrated total perfusion of the tumor in all patients. A combination of cisplatin (50 to 100 mg/m2) and floxuridine (0.01 to 0.045 mg/kg/d) was used to treat 26 patients. For these heavily pretreated patients, we observed a 43% complete and partial response rate in the subgroup of patients with squamous cell carcinoma. These results are comparable with those reported for these drugs administered systemically and for other drug combinations tested in the treatment of recurrence disease.

Adolescent↗
PubMed1999

Stability of meperidine in an implantable infusion pump using capillary gas chromatography-mass spectrometry and a deuterated internal standard.

A capillary gas chromatographic-mass spectrometric (GC MS) method is described for the analysis of meperidine using 3,3,5,5-[2H4]-meperidine as an internal standard. Chromatography was performed on a (5% phenyl) methylpolysiloxane column (30 m x 0.32 mm I.D., 0.25 microm film thickness) operated at 195 degrees C; helium carrier gas-50 cm/s(-1), tR = 2.3 min. Ionization was by electron impact (EI) and detection by selected ion monitoring of the molecular ions. The method provided high response linearity (mean r = 0.9982) and precision (< 6.5% C.V.). Application of this method to a pilot study of aqueous meperidine x HCl (10 mg/ml(-1)) stability in a surgically implantable infusion pump at 37 degrees C for 90 days revealed no demonstrable drug degradation.

Analgesics, Opioid↗
PubMedDate not supplied

Intraarterial infusion chemotherapy for head and neck cancer using a totally implantable infusion pump.

Intraarterial infusion chemotherapy has not been widely accepted for the treatment of head and neck cancer due to the high rate of complications it involves. To avoid these complications, a totally implantable infusion pump has been developed to achieve continuous low-level drug delivery for long periods of time. The pump is implanted in a subcutaneous pocket and connected to a permanent, indwelling, arterial catheter. It can be repeatedly refilled with chemotherapeutic agents by hypodermic needle injection through the skin and through a self-sealing septum located at the entry to the pump. Refilling the pump recharges an inexhaustible power source for the next delivery cycle. Preliminary results suggest that long term intraarterial infusion chemotherapy for the treatment of head and neck cancer is practical for outpatients.

Antineoplastic Agents↗
PubMed1999

First clinical experience with a high-capacity implantable infusion pump for continuous intravenous chemotherapy.

PURPOSE: To evaluate the efficiency of a new high-capacity pump for systemic venous chemotherapy and to verify the quality of implantation by interventional radiology staff. METHODS: A total of 47 infusion pumps with a 60-ml reservoir and variable flow rates (2, 6, 8, or 12 ml/24 hr) were implanted by radiologists in 46 patients with solid tumor metastases requiring treatment with a single, continuously infused cytostatic agent. The reservoir was refilled transcutaneously, usually once weekly. The flow accuracy of the pump was assessed from actual drug delivery recorded on 34 patients over a minimum observation period of 180 days. RESULTS: No early complications occurred in any of the 47 implants in 46 patients. A total of 12 (25.53%) complications occurred between 3 and 24 months after implantation. Seven (14.90%) of these were due to the external design of the pump, while five (10.63%) were related to the central venous catheter. In the 34 patients available for pump evaluation (follow-up of at least 180 days), the system was used for a total of 14,191 days (range 180-911 days, mean 417.38 days), giving an overall complication rate of 0.84 per 1000 days of operation. The mean flow rate accuracy was 90.26%. CONCLUSION: The new implantable pump showed good flow rate accuracy and reliable operation. The pump-related complications were related to its external design and have now been corrected by appropriate modifications. From a radiologic and surgical viewpoint, the venous implantation procedure is identical to that of conventional vascular access devices and can be performed by radiologists familiar with these techniques. The current limitations lie in the high cost of the pump and, for certain drugs, the short time between refills.

Adult↗
PubMed1985

Implantable infusion pump management of insulin resistant diabetes mellitus.

Diabetes mellitus with resistance to insulin administered subcutaneously or intramuscularly (DRIASM) is a rare and brittle form of Type I diabetes, found predominantly in young females and characterized by inadequate glycemic response to subcutaneous or intramuscular insulin administration. DRIASM leads to frequent ketoacidosis and obligatory hospitalization for administration of intravenous insulin. The use of a totally implantable infusion pump effected dramatic improvement in the treatment of five patients with this difficult form of diabetes. Frequency of clinical ketoacidosis was reduced from 37 episodes per year to 0.4 episodes per year (99%), and average in-hospital days per month were reduced from 20.8 days to 2.2 days (89%) with a mean follow-up period of 14.4 months. Cost savings were approximately +10,000 per patient month. Quality of life was greatly improved for these individuals.

Adolescent↗