DVT - Living With Deep Vein Thrombosis

Medical Implants
Questions are posed concerning the integrity of medical appliances when exposed to the increased barometric pressures associated with SCUBA diving. Many individuals with disabilities such as spina bifida have connections between the brain anf the abdominal cavity (ventriculoperitoneal shunts) for the treatment of hydrocephalus (excessive fluid on the brain). Huang et al.10 subjected four ventriculoperitoneal shunts to one and four atmosphere absolute in a hyperbaric chamber and found that all shunts performed according to manufacturers’ specifications. They reasoned that any increase in pressure will compress all fluid-filled compartments. Therefore, there would be no significant change in gradient between intracranial and intraperitoneal pressures. Preliminary studies have been carried out for cochlear implants in a hyperbaric chamber, illustrating that the implantable components of various cochlear implants can withstand pressures of up to six atmospheres without damage or failure of critical seals.11

Intrathecal baclofen pumps are increasingly being utilized in the management of spasticity and dystonia. Akman et al.12 described a case of retrograde leakage of cerebrospinal fluid (CSF) into the infusion pump reservoir of an intrathecal baclofen pump (Medtronic SynchroMed, Medtronic, Minneapolis, MN) during hyperbaric oxygen therapy. Medtronic does not recommend exposing their intrathecal baclofen pumps to pressures of 2 atmospheres absolute (SynchroMed II Technical Manual, Medtronic).