Adenosine-Releasing Guide Wire for No-Reflow Prevention
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Solution Overview
Problem
Current vascular interventional procedures, such as PCI and stent implantation, often result in the no-reflow phenomenon due to embolization and microvascular injury, leading to impaired tissue perfusion and increased mortality, with existing devices like FilterWire and GuardWire failing to effectively prevent these complications.
Innovation Solution
Development of guide wires coated with medications like adenosine or adenosine analogues that release into the downstream microvascular bed during procedures, using polymers that link adenosine molecules covalently or incorporate free molecules, to attenuate the no-reflow phenomenon by improving blood flow and reducing embolization.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If guide wire, balloon, stent or embolic protection device is introduced during vascular interventional procedure, then vessel patency is restored or maintained, but tissue blood flow is compromised through macro-embolization of thrombotic and atherosclerotic debris
Solution Approach 1:
A distal protection device is introduced as an intermediary component between the intervention devices and the distal vasculature. This device includes a filter or occlusion element that intercepts embolic debris before it can reach downstream tissues, allowing the guide wire, balloon, and stent to perform their primary functions while the protection device simultaneously prevents macro-embolization
Solution Approach 2:
The distal protection device is deployed before the atherectomy, balloon inflation, or stent deployment procedures. By establishing the protective barrier in advance, the device prevents embolic debris from dislodging during subsequent interventions, thereby preventing macro-embolization before it can occur
2Reliability
If vascular interventional procedure is performed in the presence of occlusive thrombus, then vessel occlusion is relieved, but tissue blood flow is compromised through micro-embolization or microvascular injury from reperfusion
Solution Approach 1:
Pharmacologic agents serve as intermediary substances that modify the biological response of microvessels to reperfusion. These agents reduce platelet activation, inhibit neutrophil-mediated damage, and prevent vasoconstriction in the distal microcirculation, thereby protecting against micro-embolization and reperfusion injury while allowing blood flow restoration
Solution Approach 2:
The reperfusion process, which normally causes microvascular injury through platelet activation and neutrophil infiltration, is converted into a beneficial outcome by simultaneously administering pharmacologic protection. The same reperfusion that risks causing no-reflow phenomenon is transformed into effective tissue revascularization when protected by the pharmacologic agents
3Object-affected harmful factors
If embolic protection device is used to prevent macro-embolization, then distal tissue perfusion is improved, but device complexity and procedural time increase
Solution Approach 1:
The distal protection device is designed to be universally applicable across different vascular territories and intervention types. The same basic device architecture can be used in coronary, carotid, and peripheral interventions, reducing the need for specialized equipment and simplifying the learning curve for operators
Solution Approach 2:
The distal protection function is merged with the guide catheter or delivery system, combining multiple functions into a single integrated device. This reduces the number of separate components that must be manipulated and deployed, thereby simplifying the overall procedure
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The guide wires effectively release adenosine or adenosine analogues to improve microcirculatory flow, inhibit thrombosis, and reduce cytotoxic effects, thereby reducing vascular damage and improving outcomes in vascular interventional procedures by preventing the no-reflow phenomenon.
Implementation Method 1
The medications that can be released from the guide wire include, but are not limited to, adenosine, adenosine analogues, an agonist of one or more of the adenosine receptors
Implementation Method 2
using polymers that link adenosine molecules covalently or incorporate free molecules
Data Source
AI summary
The present invention relates to compositions and methods for improving outcomes in vascular interventional procedures. In particular, the present invention relates to compositions and methods for improving outcomes in vascular interventional procedures using an anti-no-reflow guide wire that attenuates the “no-reflow” phenomenon that is associated with negative outcomes.