Ares Antibiotic-Impregnated Catheters

Ares Antibiotic-Impregnated Catheters

The Ares^™ Antibiotic-Impregnated Catheters are designed to reduce the colonization of gram-positive bacteria. Laboratory tests show these antibiotic-impregnated catheters provide antimicrobial activity for at least the first 31 days, the time when patients are most susceptible to shunt infections.^1-4

For added convenience, Ares Antibiotic-Impregnated Catheters have the same diameters as our standard catheters. This enables seamless connection to all Strata^®, Delta^®, and PS Medical^® shunt valves, so you don’t have to mix different shunt brands to get the best of both worlds.

Functional and Convenient

• Impregnated with two antibiotics: rifampicin and clindamycin
• Shown to reduce colonization of gram-positive bacteria on all catheter surfaces
• Small quantity of antibiotics (less than a pediatric daily dose) results in low risk of toxicity
• Very low risk of resistance mutation due to dual antibiotics that are hard to resist simultaneously^1,10
• Numerical length marks clearly show depth of penetration during ventricular catheter placement
• Features same-sized tubing as Medtronic’s standard non-antibiotic-impregnated catheters to resist kinking and compression
• Designed to fit all Medtronic shunt valves
• Barium impregnation allows for visualization of the catheter on x-ray
• Non-ferrous design won’t interfere with CT scans or MRI
• Ventricular catheters include a stainless steel stylet and patented right-angle clip that provides a non-kinking bend in the catheter at the burr hole site

Important Safety Information

Shunt obstruction may occur in any of the components of the shunt system. The ventricular catheter may become occluded by particulate matter such as blood clots or brain fragments, by investment of the catheter tip in choroid plexus, by embedding of the catheter in brain tissue, or by coaptation of the ventricular walls in the presence of overdrainage ("slit ventricles"). It is important to review the product labeling for complete safety information, potential complications, contraindications, and a complete explanation of warnings and precautions.

Research shows that there is an increased risk of shunt valve infection in younger patients, especially premature infants, patients who have had a previous shunt infection, and patients who have been on an external drainage system. Shunt infections are associated with much greater morbidity for patients, as well as increased costs to healthcare providers and society. Complications include additional surgeries and lengthened hospital stays, developmental disabilities and loss of IQ, and death.

How Ares Antibiotic-Impregnated Catheters Work

Ares Ventricular Catheters

The Ares^™ ventricular catheter comes packaged with a stainless steel stylet and a patented right-angle clip that provides a non-kinking bend in the catheter at the burr hole site. Once the Ares ventricular catheter is implanted, the stylet is removed, and the catheter can be attached to the shunt valve using a catheter connector and an encircling ligature. There are a variety of catheter connectors for the surgeon to choose from.

Ares Peritoneal Catheters

The Ares peritoneal catheter can be attached to the distal (far) end of the hydrocephalus valve, indicating the direction of CSF flow away from the brain to another CSF diversion site that the surgeon chooses.

The length of the Ares peritoneal catheter is sufficient for placement in adults or it may be trimmed to the appropriate length by the surgeon. A catheter passer is required to make a subcutaneous tunnel for the peritoneal catheter to fit through.

Ares Ventricular Catheters and Peritoneal Catheters can be used with any Strata^®, Delta^®, or PS Medical^® valve as part of a complete shunt system.

A more complete explanation of pre-operative handling and assembly methods for Medtronic Ares Antibiotic-Impregnated Catheters is listed in the Instructions for Use.

Important Safety Information

The most common complications associated with this product are due to obstruction of the system, infection, and mechanical malfunction. Catheters may become kinked, disconnected, or blocked. It is important to review the product labeling for complete safety information, potential complications, contraindications, and a complete explanation of warnings and precautions.

References

1. Bayston R, Ashraf W, Bhundia C. Mode of action of an antimicrobial biomaterial for use in hydrocephalus shunts. Journal of Antimicrobial Chemotherapy 2004; 53:778-782.
2. Pattavilakom A, Kotasnas D, Korman TM, Xenos C, Danks A. Duration of in vivo antimicrobial activity of antibiotic-impregnated cerebrospinal fluid catheters. Neurosurgery 2006; 58:930-935.
3. Richards HK, Seeley HM, Pickard JD. Efficacy of antibiotic-impregnated shunt catheters in reducing shunt infection: data from the United Kingdom Shunt Registry. J Neurosurg Pediatrics 2009; 4:389-393.
4. Parker SL, Attenello FJ, Sciubba DM, Garces-Ambrossi GL, Ahn E, Weingart J, Carson B, Jallo GI. Comparison of shunt infection incidence in high-risk subgroups receiving antibiotic-impregnated versus standard shunts. Childs Nerv Syst 2009; 25:77-83.
5. Attenello FJ, Garces-Ambrossi GL, Zaidi HA, Sciubba DM, Jallo GI. Hospital costs associated with shunt infections in patients receiving antibiotic-impregnated shunt catheters versus standard shunt catheters. Neurosurgery 2010; 66:284-289.
6. Patwardhan RV, Nanda A. Implanted ventricular shunts in the United States: the billion-dollar-a-year cost of hydrocephalus treatment. Neurosurgery 2005; 56:139-145.
7. Darouiche RO. Treatment of infections associated with surgical implants. N Engl J Med 2004; 350(14):1422-1429.
8. Browd SR, Ragel BT , Gottfried ON, Kestle JR. Failure of cerebrospinal fluid shunts: part I: Obstruction and mechanical failure. Pediatr Neurol 2006 February;34(2):83-92.
9. Ratilal B, Costa J, Sampaio C. Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts: a systematic review. J Neurosurg Pediatrics 1:48-56, 2008.
10. Kohnen W, Kolbenschlag C, Teske-Keiser S, Jansen B. Development of a long-lasting ventricular catheter impregnated with a combination of antibiotics. Biomaterials 2003 November;24(26):4865-9.