Aortic Dissection Catheter Assembly for Electrosurgical Membrane Slitting
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Solution Overview
Problem
Current treatments for aortic dissection, particularly in managing aortic arch and thoracoabdominal aneurysms, face challenges such as a narrow true lumen, risk of stent obstruction by thick dissection flaps, and difficulty in deploying endografts due to aortic branches perfused by the false lumen, leading to high patient mortality and morbidity.
Innovation Solution
A method and catheter assembly are used to slit the dissection membrane of the aorta by inserting two catheters into the true and false lumens and applying electrical current through an electrically conductive wire to create a common lumen, enabling endovascular stent graft implantation and addressing issues like compressed true lumen and aortic branch perfusion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If stenting the aorta with an endograft is performed, then the aorta can be reinforced and blood flow restored, but the narrow true lumen and thick dissection flap cause stent obstruction and make endograft alignment difficult
Solution Approach 1:
The dissection membrane is divided into multiple segments by creating radial slits at intervals along the aorta. This segmentation converts the single narrow true lumen into multiple channels, allowing the endograft to be deployed through one of the slitted channels without being obstructed by the dissection flap, while still providing comprehensive reinforcement of the entire aortic segment
Solution Approach 2:
The true lumen is expanded from a two-dimensional narrow slit into a three-dimensional multi-channel structure by creating radial slits that extend through the dissection membrane. This dimensional transformation creates sufficient space for endograft passage and deployment while maintaining structural integrity through the distributed slit configuration
2Adaptability or versatility
If the true lumen is enlarged by slitting the dissection membrane, then endograft placement becomes feasible, but the procedural complexity and risk of complications increase
Solution Approach 1:
The catheter assembly is designed with multi-functionality, combining wire delivery, electrocautery cutting, and dissection membrane slitting capabilities in a single device. This universal design simplifies the overall procedure by eliminating the need for multiple separate devices and steps, thereby reducing procedural complexity while achieving true lumen enlargement for endograft placement
3Object-generated harmful factors
If replacement of the ascending aorta with resection of the entry site is performed, then the primary tear is removed, but the downstream dissected aorta with patent false lumen remains untouched leading to post-dissection aneurysms
Solution Approach 1:
The treatment combines ascending aorta replacement with downstream dissection membrane slitting in a single integrated procedure. The endograft is deployed through the slitted true lumen extending into the descending aorta, providing continuous reinforcement from the ascending through the arch to the thoracoabdominal region. This merged approach simultaneously addresses the primary tear and prevents downstream aneurysm formation by reinforcing the entire aortic pathway
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 method safely enlarges the true lumen, facilitating endograft placement and resolving contradictions for thoracoabdominal endovascular repair, reducing the risk of complications and improving patient outcomes.
Implementation Method 1
applying an electrical current to the wire; and slitting the dissection membrane by moving the wire relative to the dissection membrane
Data Source
AI summary
The catheter assembly for slitting a dissection membrane of an aorta of a patient includes a first catheter configured to be inserted into a true lumen located on a first side of the dissection membrane a second catheter configured to be inserted into a false lumen located on a second side of the dissection membrane, and an electrically conductive wire electrically conductively joined to the first and the second catheters. The wire is further configured to be energized with electrical current such that the dissection membrane can be slit by the wire A method is also provided.