Events/Publications

Note: the content in these publications is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Filtration of SAH via Spinal Catheter

University of Texas at Houston

Accepted for publication in Operative Neurosurgery

The amount of subarachnoid blood and the presence of toxic blood breakdown products in the cerebrospinal fluid (CSF) has long been associated with poor outcomes in aneurysmal subarachnoid hemorrhage (aSAH). The Neurapheresis™ system has been developed to filter CSF and remove blood products and is being investigated for safety and feasibility in the ExtracorPoreal Filtration of Subarachnoid Hemorrhage via SpinaL CAtheteR (PILLAR) study. We report the first case using this novel device.

A Novel Therapeutic Approach for Leptomeningeal Metastases

Duke University School of Medicine/Minnetronix Neuro

Mayo Clinic Neuroscience and Oncology Innovation Summit 2017 –
December 14-16, 2017 – Orlando, FL

Leptomeningeal Metastases (LM) occurs when primary tumor cells metastasize, invade the subarachnoid space, and spread throughout the cerebrospinal fluid (CSF). As novel cancer therapies extend survival, LM has become increasingly prevalent, with approximately 110,000 diagnoses per year in the U.S.1 Despite advances in targeted radiation and chemotherapy, survival averages 3-6 months after LM diagnosis.2,3 Reducing tumor burden is the primary goal to extend survival and quality of life. We propose an intrathecal catheter-based extracorporeal filtration system (NeurapheresisTM therapy) as an alternative mechanical intervention for the filtration of tumor cells and distribution of chemotherapeutics in the CSF. Here, we demonstrate the ability of our system to reduce VX2 carcinoma cells in vitro.

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under award number R41CA206742 (100% support, $224,970)

In Vitro Characterization of the Neurapheresis™ System for the Treatment of Cryptococcal Meningitis

Duke University Medical Center/Minnetronix Neuro
ID Week 2017 – October 4-8, 2017 – San Diego, CA

Cryptococcal Meningitis is caused by Cryptococcus neoformans and is the most common cause of fungal meningitis in adults. Treatment for Cryptococcal Meningitis is based on an induction, consolidation, and maintenance approach with antifungals, but is associated with continued high morbidity and mortality. A catheter-based extracorporeal filtration system (Neurapheresis™ Therapy) for the filtration of infected CSF is a potential alternate or adjunctive intervention. This poster, produced with Duke University describes the in vitro characterization of Neurapheresis™ Therapy as an alternative mechanical intervention for filtration of C. neoformans cells, polysaccharide antigen, and inflammatory mediators from infected CSF.

Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under award number R41AI120304 (100% support, $1,711,835)

Feasibility of Neurapheresis™ Therapy for
Multidrug Resistant Gram-negative Bacterial Meningitis

Duke University Medical Center/Minnetronix Neuro
ID Week 2017 – October 4-8, 2017 – San Diego, CA

Pseudomonas, Acinetobacter and Klebsiella are three multidrug resistant (MDR) gram-negative pathogens that pose a threat to human health. Patients in hospitals or nursing homes, and with devices such as intravenous catheters or ventilators are at increased risk of Gram-negative bacterial meningitis (GBM) from these bacteria. GBM manifests when these bacteria invade the central nervous system. Increasingly antibiotic resistant bacteria strains cause high mortality associated with MDR GBM. This poster demonstrates the feasibility of Neurapheresis™ Therapy for MDR GBM, and characterizes system parameters for bacterial, endotoxin, and cytokine clearance.

Leptomeningeal disease: current diagnostic and therapeutic strategies

Gautam Nayar, Tiffany Ejikeme, et al
Oncotarget – August 16, 2017

Abstract: Leptomeningeal disease has become increasingly prevalent as novel therapeutic interventions extend the survival of cancer patients. Although a majority of leptomeningeal spread occurs secondary to breast cancer, lung cancer, and melanoma, a wide variety of malignancies have been reported as primary sources. Symptoms on presentation are equally diverse, often involving a combination of neurological deficits with the possibility of obstructive hydrocephalus. Diagnosis is definitively made via cerebrospinal fluid cytology for malignant cells, but neuro-imaging with high quality T1-weighted magnetic resonance imaging can aid diagnosis and localization. While leptomeningeal disease is still a terminal, late-stage complication, a variety of treatment modalities, such as intrathecal chemotherapeutics and radiation therapy, have improved median survival from 4–6 weeks to 3–6 months. Positive prognosticative factors for survival include younger age, high performance scores, and controlled systemic disease. In looking to the future, diagnostics that improve early detection and chemotherapeutics tailored to the primary malignancy will likely be the most significant advances in improving survival.

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under award number R41CA206742 (100% support, $224,970)

A Novel Therapeutic Approach for Cryptococcal Meningitis

Duke University School of Medicine/Minnetronix Neuro
ID Week 2016 – October 26-30, 2016 – New Orleans, LA

Cryptococcal meningitis (CM) is a devastating opportunistic infection that primarily presents in immunocompromised patients. CM is caused when Cryptococcus neoformans, a basidiomycete fungal pathogen, invades the central nervous system (CNS) and circulates within cerebospinal fluid (CSF) around the brain and spinal cord in the subarachnoid space. Current treatment guidelines include two weeks of continuous intravenous administration of amphotericin B and flucytosine, and maintaining a fungicidal regimen for six months. The single most important factor impacting survival has been shown to be rapid reduction of C. neoformans organisms in CSF during the first two weeks of infection. This poster describes an experimental filtration system, demonstrating a 1-2 log reduction in CSF organism burden using an infected rabbit model of CM.

Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under award number R41AI120304 (100% support, $1,711,835)

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