Central Venous Occlusion Access Catheter with Stiff Working Section
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Solution Overview
Problem
Existing methods for accessing the central venous system through occluded vessels in the neck region, such as those described in Pillai and Evans, are ineffective when a major vein is blocked by a clot or fibrous occlusion, requiring the sequential sacrifice of major vessels, which is undesirable.
Innovation Solution
A catheter system is used to access the central venous system through an occluded large vessel in the neck by initially entering from the groin area and using a working catheter with a stiff section to navigate through the occlusion, guided by a radiopaque marker on the patient's surface, allowing a needle wire to be aimed and launched along a straight trajectory to a predetermined exit location near the clavicle.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional direct puncture technique is used to access central venous system, then access can be obtained through major veins in the neck, but the procedure fails when a major vein is blocked with clot or fibrous occlusion
Solution Approach 1:
The patent inverts the conventional approach by entering the central venous system from the distal end (femoral vein in the groin) rather than from the proximal end (neck veins). This reverse approach allows the catheter to traverse the occluded segment from the distal direction, enabling access even when proximal vessels are blocked by clots or fibrous occlusions.
Solution Approach 2:
The patent introduces a new dimensional approach by using a long working catheter that extends through the entire length of the occluded vessel segment. The catheter system operates in a three-dimensional trajectory, with the working catheter shaft extending from the femoral vein through the occlusion to the superior vena cava, creating a new pathway dimension that bypasses the blockage.
2Ease of operation
If sequential sacrifice of major vessels is performed to access central venous system, then access can be obtained through alternate vessels, but the practice is undesirable due to increased morbidity and complexity
Solution Approach 1:
The patent performs preliminary action by pre-positioning a radiopaque target marker on the patient's skin at the intended exit site before the procedure. This marker serves as a guide during catheter insertion, allowing the working catheter to be accurately positioned and exited through a predetermined location without requiring complex real-time navigation or sequential vessel sacrifices.
Solution Approach 2:
The patent introduces an intermediary element in the form of a radiopaque target marker that mediates between the operator and the deep anatomical structures. This marker serves as a visible guide that simplifies the insertion process by providing a clear exit point reference, eliminating the need for complex sequential vessel sacrifices and reducing procedural complexity.
3Strength
If a stiff working section is used in the catheter, then the catheter can be pushed and torqued to force the tip into the occlusion, but the catheter may not be able to navigate curved paths
Solution Approach 1:
The patent segments the catheter into distinct functional sections: a proximal portion that is flexible for navigation through the femoral vein and pelvic vessels, and a distal working section that is stiff for forcing into the occlusion. This segmentation allows each portion to optimize its specific function without compromising the other.
Solution Approach 2:
The patent applies local quality by making different portions of the catheter have different mechanical properties. The proximal portion is designed with high flexibility for easy navigation, while the distal working section is designed with high stiffness for forcing into the occlusion. This localized differentiation of mechanical properties allows the catheter to navigate curved paths while still being able to force its tip into the occluded vessel.
Data Source
AI summary
A catheter system for accessing the central venous system through an occlusion in the neck region.