# Comprehensive Engineering Performance Evaluation of the IRRAflow Active Fluid Exchange System with IRRAS Bolt for Intracranial Fluid Management

**Authors:** Behnam Rezai Jahromi, Riam Badr, Dave Asbury, John Unser

PMC · DOI: 10.7759/cureus.100435 · 2025-12-30

## TL;DR

This paper evaluates a new medical device for managing intracranial pressure and cerebrospinal fluid in neurological patients.

## Contribution

The study introduces a comprehensive engineering evaluation of a novel intracranial fluid management system.

## Key findings

- The IRRAflow system met predefined criteria for catheter-bolt sealing and fluid equilibrium.
- The device demonstrated accurate pressure readings and acceptable 24-hour drift in sensor output.

## Abstract

The IRRAflow Active Fluid Exchange System (IRRAS, San Diego, California, USA) is a novel medical device designed to manage intracranial pressure (ICP) and cerebrospinal fluid (CSF) in patients with neurological conditions such as subarachnoid hemorrhage (SAH), intraventricular hemorrhage (IVH), and chronic subdural hematoma (cSDH). This study presents a series of evaluations assessing the system’s performance across multiple technical aspects: catheter-bolt sealing, catheter liquid flow characterization with bolt fixation, torque limit evaluation of the metal bolt and plastic wing interface, fluid equilibrium, injection volume accuracy, 24-hour pressure drift evaluation of IRRAflow ICP sensor output, and pressure accuracy. The results are reported relative to predefined acceptance criteria for each test. The engineering and potential clinical implications of these findings are described in the context of intracranial fluid management.

## Linked entities

- **Diseases:** subarachnoid hemorrhage (MONDO:0005099)

## Full-text entities

- **Diseases:** SAH (MESH:D013345), IVH (MESH:D000074042), cSDH (MESH:D020200)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

15 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12854789/full.md

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Source: https://tomesphere.com/paper/PMC12854789