Bioabsorbable Platform Device for Arteriovenous Fistula Anastomosis
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Solution Overview
Problem
The creation of arteriovenous fistulas (AVFs) for hemodialysis patients is hindered by complications such as perianastomotic stenosis and turbulent blood flow, leading to failed maturation and reduced effectiveness of the AVF.
Innovation Solution
A platform device comprising a bioabsorbable filament and a coil structure is used to support the vessel during and after surgical intervention, minimizing turbulent blood flow by adjusting the anastomosis angle and promoting laminar flow.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a traditional anastomosis is created between artery and vein, then the AVF is formed for hemodialysis access, but perianastomotic stenosis and turbulent blood flow occur leading to failed maturation
Solution Approach 1:
A bioabsorbable platform device is introduced as an intermediary structure between the artery and vein at the anastomosis site. The platform provides mechanical support and guidance during the critical maturation period, then gradually degrades and is absorbed by the body. This intermediary structure helps maintain proper geometry and reduces turbulent flow, allowing the vessels to mature successfully before the platform disappears.
Solution Approach 2:
The platform device is implanted before the anastomosis is fully matured to preemptively address potential maturation failures. By providing structural support and optimizing blood flow patterns in advance, the platform prevents the development of stenosis and turbulence that would otherwise occur during the vulnerable early maturation phase.
2Stability of the object's composition
If the anastomosis angle is not optimized, then the surgical procedure is simpler, but turbulent blood flow occurs preventing proper vein growth and maturation
Solution Approach 1:
The platform device incorporates curved and angled geometric features that guide blood flow smoothly from the artery into the vein. The platform's three-dimensional structure is designed with specific curvature radii and angle configurations that promote laminar flow patterns, eliminating turbulence while the vessels mature.
3Duration of action of stationary object
If a permanent support structure is used at the anastomosis site, then structural stability is maintained, but the device causes long-term foreign body presence and potential complications
Solution Approach 1:
The platform device is constructed from bioabsorbable materials whose mechanical and chemical properties change over time. The material gradually degrades from a strong, structurally supportive state to a weakened state as it is broken down and absorbed by the body. This parameter change allows the device to provide temporary support during maturation, then disappear completely, eliminating long-term foreign body presence.
Data Source
AI summary
There is described a platform device for use in forming an anastomosis and maintaining a desired curvature of a lumen in a desired shape during an anastomosis assistance period. The platform is formed from one or more bioabsorbable or biodegradable polymer filaments. There is also described a method for inserting a platform device for use in creation of an arteriovenous fistula by identifying a candidate artery and a candidate vein and dissecting the candidate vein. Next, inserting a platform device into the vein and creating a breach in the candidate artery at a desired angle and location. Next, introducing the platform device and vein into the candidate artery and forming the platform device into a curvature angle selected to minimize turbulent blood flow in an anastomosis formed by the vein and the artery. The platform may also be used to maintain potency of supply blood vessels and/or organ blood vessels or the lumens during an organ transplant procedure.