Transcript Pulmonary Embolism Extraction Catheter Development

Pulmonary Embolism Extraction
Catheter Development
Trip Cothren
Lauren Nichols
Dustin Temple
Advised by: Dr. Michael Barnett, VUMC
Cardiology
Problem



There are over 600,000 cases of
pulmonary embolisms annually in the
United States, which result in nearly
60,000 fatalities.
Systemic thrombolytics can be dangerous
Is there a catheter solution that can
quickly remove PE in the hospital setting?
Thrombolytics




Medicine used to dissolve blood clots
Risk of bleeding in other organs
Vascular injury at injection site
Great risk of stroke in the elderly
• Elderly is our target population
Goals

The goal of this project is to design a catheter that
can efficiently remove an embolism from the
pulmonary artery. The main goals of the project are:
•
•
•
To research and evaluate current technology in pulmonary
embolism extraction
To design a catheter that can successfully remove
embolisms percutaneously and completely without damage
to the patient
To produce a feasible prototype of our design
Our Design

Combined ideas from multiple existing
medical products
• Inferior vena cava filter
• Absorbable hemostat
• Local clot busting drug administration

Security from multiple backups
Filter




Based off inferior vena
cava filter
Umbrella-like device
Expandable to various
sizes
Combined to reduce
stress on vessel wall
Surgicel or Gelita

Material that attracts clots

Coat prongs of filter
Prevent clots pieces
from going downstream
Made by Ethicon


• Oxidized cellulose polymer
• Used clinically for over 50 years
Trellis Catheter Device

Inflatable back-end
“clot-catching” device

Local drug delivery

Use of guide wire
Preliminary CAD
Design






Length of 2m
Stainless steel guidewire diameter of
0.75mm
Silicone sheath
Outermost diameter of 6F (2mm)
Titanium basket
Surgicel coated on basket prongs
Procedure





Clot localized with x-ray angiography
Catheter inserted through femoral vein
Procedure time less than 1 hour
Basket device pushed through clot, then
sheath removed and basket expanded
tPA locally administered and catheter
pulled back out with clot pieces attached
Cost of Comparison Devices


Trellis Device
•
$2095 for complete device
AngioJet
• $38,000 for drive unit
• $650 - $2050 for disposables (catheters)
Price
Item
Surgicel
Description
Matrix for platelet
adhesion
Amount Needed
Price
1 - 0.5''x2'' piece
273.4/piece
22.78
Guidewire
Stainless Steel Wire 2 m, 0.75mm diameter
13.99/300in
3.73
Catheter Sheath
Silicon Tube
2 m, 2mm diameter
0.2/ft
1.3
Drug Eluting Sheath
Silicon Tube
2 m, 1mm diameter
0.2/ft
1.3
Basket
Titanium
150 mm, 0.1mm
27/25ft
Raw Material
Cost
Price/Instrument
0.54
29.65
Potential Problems





Hemolysis causes release of adenosine
when cells lyse
Bradycardia or heart failure
Renal failure
Unpredictable thrombolytic tolerance
Mechanical damage to vessel wall
Future Work



Refine model using
Pro Engineer or
AutoCAD
Further work with
prototype
DesignSafe
References



http://www.medgadget.com/archives/img
/sidcath.jpg
http://www.socalcardiology.com/media/a
ngiojet.jpg
http://www.lexmed.com/images/cathphot
o2.jpg