Guide Catheter Wire Loop for Single Puncture IAS Crossing
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Solution Overview
Problem
The challenge lies in facilitating the passage of an intracardiac echo (ICE) probe across the interatrial septum (IAS) while maintaining a single puncture site, which is crucial for minimizing patient risk and ensuring precise imaging for LAA closure procedures.
Innovation Solution
A system comprising a guide catheter with at least two lumens, housing both a probe and a wire with a retractable and resizable distal loop, allows for the simultaneous guidance of the ICE probe and the LAA sheath across the IAS through a single puncture site.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the ICE probe is tracked across the IAS using the shoehorn technique with positioning at the puncture site, then the probe can be introduced into the LA via a single TSP, but the positioning at the puncture site and anatomic features of the IAS make crossing the IAS difficult
Solution Approach 1:
A guide catheter is introduced as an intermediary device to facilitate the tracking of the ICE probe across the IAS. The guide catheter provides a pre-formed pathway with appropriate curvature and support, mediating between the puncture site and the target location in the left atrium, thereby making the crossing procedure easier while maintaining the single puncture site approach
2Ease of operation
If two separate TSP sites are used to track the ICE probe and LAA sheath, then both devices can access the LA, but this causes more risk to the patient than using one site
Solution Approach 1:
The guide catheter merges the pathways for both the ICE probe and LAA sheath into a single puncture site. By providing a common access route with multiple lumens or openings, the guide catheter allows both devices to reach the left atrium through one puncture, thereby eliminating the need for a second puncture site and reducing patient risk
3Measurement precision
If the ICE probe is positioned in the LA along with the LAA sheath for continuous ultrasound monitoring, then imaging accuracy is improved, but proper placement becomes challenging
Solution Approach 1:
The guide catheter serves as an intermediary that simplifies the placement of the ICE probe. By providing a pre-positioned pathway and potential positioning features (such as side openings or engagement mechanisms), the guide catheter makes it easier to achieve proper ICE probe placement in the left atrium for continuous ultrasound monitoring, thereby reducing placement complexity while maintaining imaging accuracy
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
This approach enables continuous ultrasound monitoring and precise placement of the ICE probe in the left atrium, enhancing the accuracy and safety of LAA closure procedures by reducing the need for multiple puncture sites.
Implementation Method 1
an ICE probe, which can be positioned in the LA along with the LAA sheath
Data Source
AI summary
Devices and methods are described for facilitating passage of a probe or other element across an anatomical boundary. In some embodiments, the probe may be an intracardiac echo (ICE) probe, and the anatomical boundary may be the interatrial septum (IAS). The probe is delivered via transcatheter access from a femoral vein to the right atrium using a moveable guide catheter through which the probe and a wire with a resizable distal loop are advanced. The probe and wire may extend through respective lumens of the guide catheter. The loop may be resized to track, capture, and release a sheath, such that a transcatheter delivered medical device such as a left atrial appendage (LAA) occlusion device or other device, may traverse the IAS with the ICE probe via a single puncture site.