Uncloggable ventriculoperitoneal shunt system for hydrocephalus via an integrated soft robotic device: CLEARS device

Ventriculoperitoneal (VP) shunt obstruction, often caused by protein and fat accumulation at the ventricular catheter ports, impedes cerebrospinal fluid (CSF) outflow, increases intracranial pressure (ICP), and leads to hydrocephalus. Current treatments require invasive shunt removal, reimplantation, or retrograde flush cleansing. We present a next-generation VP shunt system that actively removes blockages via external actuation. Our system, called CLogging Elimination ActuatoR Silicone (CLEARS), integrates a soft, expandable silicone tube within the catheter lumen. This soft robotic insert, capable of 900% strain, can inflate to dislodge blockages and then deflate to restore flow. To test CLEARS, we developed an ex vivo model simulating CSF flow and obstruction using a rapidly acting clogging agent. ICP upstream of the catheter was monitored to evaluate performance. When obstructed with 3 g of the clogging agent, ICP rose to 30 cmH\(_2\)O. Upon CLEARS activation, the silicone insert expanded through catheter ports and successfully removed the clog, restoring baseline ICP (\(\sim\)0 cmH\(_2\)O) within approximately 40 s. Without the system, obstruction persisted and pressure remained elevated. Visual documentation confirmed the mechanism of action. The CLEARS system offers a promising solution to VP shunt occlusion by enabling non-invasive mechanical declogging. Our model replicates shunt obstruction and CSF dynamics, providing a testbed for device evaluation. The expandable insert maintained catheter flow and reduced ICP to normal levels after obstruction, representing a potential shift in how hydrocephalus is treated.