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NANS I3 Technology Gaps in Intrathecal Drug Delivery Systems Stanley Fisher, M.D. Associate Professor of Neurology Weill Cornell Medical College Co-Director, Movement Disorders and Neurorehabilitation Center Methodist Neurological Institute Houston, Texas Slide 2 Desired improvements in IT Drug Delivery? Reliable pumping mechanism. Long battery life. Troubleshooting tools. Enhanced safety features. Simple programming. Dependable catheter. Slide 3 MedStream Programmable Pump The system consists of: Implantable Pump 20mL and 40mL reservoirs Intrathecal Catheter(s) SureStream Intraspinal Codman Silicone Intraspinal Control Unit Indicated for: Intrathecal delivery of baclofen for severe spasticity. Slide 4 Benefits Simple & durable design. Only one moving part. > 6 million cycles without failure; equivalent to 78 years of service. Accurate dosage within 10% across the entire flow range. 4 Slide 5 Benefits Fewer revision surgeries. Higher infusion rates can be used without effecting battery life. Typical peristaltic pump lasts only 5-7 years depending on flow rate. 5 Slide 6 Benefits Easily verify drug remaining in pump without emptying it. Confirm that drug has entered reservoir and not pump pocket. Useful diagnostic tool when troubleshooting system. 6 Slide 7 Benefits Patients can safely undergo MRI procedures. No binding of gears / rotors. No need to stop flow or empty pump before MRI. Confirm pump status after MRI 7 Slide 8 Benefits Raised refill port makes locating easy. Positive pressure provides tactile assurance that you are in the port. Drug Volume Gauge verifies that refill of pump has occurred. Safe Pump Refills Prevent pump pocket refill errors. 8 Slide 9 Easy and Fast. Slide 10 Benefits Simple and flexible dosing options. Icon-driven user interface. Backlit full-color screen. Simple roller wheel control. 10 Slide 11 Benefits Improves refill procedure efficiency and patient comfort. Rechargeable CU battery Never uses the pump battery for communication extending pump battery life. 11 Slide 12 Look Inside KinkingNo Kinking SiliconeSURESTREAM Kink Resistant The titanium coil design ensures flow of medication without occlusion. SureStream kink resistant catheter. Slide 13 Future Technology Needed Dual chamber pump. Catheter flow sensor. Therapy data trending. More drug options. 13 Slide 14 Thank You