A prospective study of catheter-related complications of intrathecal drug delivery systems

Intrathecal drug administration via implanted pump is an effective treatmen t for intractable pain and spasticity but can be compromised by catheter-re lated complications. To determine the etiology of catheter-related complica tions, we have conducted a multicenter; prospective study of the long-term performance of a one-piece catheter system. Data pertaining to catheter-rel ated complications were collected at implant and at specified times during the follow-up period. Catheter implantation characteristics that might affe ct complications were assessed. Two hundred nine patients were studied at 2 2 participating centers, with 1764 cumulative patient-months of catheter ex perience. Forty-nine catheter system complications occured in 37 patients ( 7 complications related to the catheter itself and 42 complications related to the implantation procedure). The 9-month complication-free "survival" r ate was 78.9% overall (95.5% for the catheter itself). No specific catheter implantation characteristics were associated with the occurrence of compli cations. These data indicate that the incidence of complications for a one- piece catheter system is similar to that of commercially available two-piec e systems, and highlight the need for careful surgical technique during imp lantation. (C) U.S. Cancer Pain Relief Committee, 2000.