What device is used for intrathecal chemotherapy via CSF access?

• A. Port-a-Cath
• B. Central venous line
• C. Ommaya reservoir
• D. Epidural catheter

Answer: (C)

Delivering chemotherapy directly into the CSF is most effectively done with a device that provides direct access to the ventricular system. The Ommaya reservoir is implanted under the scalp and connected to a catheter that enters a brain ventricle, usually the frontal horn. This setup allows repeated, precise intraventricular administration of chemotherapy and easier CSF sampling without the need for repeated lumbar punctures. It bypasses the blood-brain barrier so the drug reaches the CNS at therapeutic levels.

Port-a-Cath and other central venous lines are designed for venous access to deliver systemic chemotherapy; they don’t provide access to the CSF, so they’re not suitable for intrathecal delivery. An epidural catheter sits in the epidural space around the spinal cord and is used mainly for analgesia or sometimes experimental intrathecal dosing, but it doesn’t give reliable access to the ventricular CSF for intraventricular chemotherapy. The Ommaya reservoir is specifically built for intrathecal administration into the CSF, making it the best choice for this purpose.