Insulation-Modified Guidewire for Precise Transcatheter Tissue Cutting
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Solution Overview
Problem
Current transcatheter procedures for treating left ventricular outflow tract (LVOT) obstruction and myocardial tissue are limited by surgical morbidity, coronary anatomy, high pacemaker rates, and the challenge of precise tissue cutting without bystander injury.
Innovation Solution
A novel transcatheter procedure, SESAME, uses an insulation-modified guidewire with an asymmetric insulation gap to concentrate electrical charge and position the charge-delivery-device at the therapy target, accompanied by a cutting element on an elongate body and tether that cuts through tissue with relative longitudinal movement, and a system of concentrically disposed deflectable catheters for precise tissue cutting.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If surgical myectomy or alcohol septal ablation is used to treat LVOT obstruction, then the obstruction can be reduced, but surgical morbidity or high pacemaker rates occur
Solution Approach 1:
The patent replaces traditional mechanical surgical myectomy with a transcatheter electrosurgical system that uses electrical energy to cut and reduce myocardial tissue. The electrified guidewire delivers controlled electrical current to ablate septal tissue, eliminating the need for open-heart surgery and reducing surgical morbidity.
Solution Approach 2:
The patent introduces an insulation-modified guidewire as an intermediary device that delivers electrical energy precisely to the target tissue. The guidewire acts as a mediator between the external power source and the myocardial tissue, enabling controlled tissue reduction without direct surgical intervention.
2Ease of manufacture
If an electrified guidewire is used to cut tissue, then tissue cutting can be achieved, but bystander tissue injury may occur due to charge concentration on the outer aspect of the kink
Solution Approach 1:
The patent applies asymmetry by positioning the insulation gap specifically on the inner curvature of the guidewire kink rather than symmetrically. This asymmetric placement ensures that the electrical charge is delivered only to the intended target tissue on the inner curve, preventing charge dispersion to surrounding bystander tissues.
Solution Approach 2:
The patent creates local quality by concentrating the electrical charge delivery to a specific localized area (the inner curvature of the kink) through the strategically placed insulation gap. This ensures that only the precise target tissue receives the cutting energy, while adjacent tissues remain protected.
3Manufacturing precision
If a cutting element is moved longitudinally to cut tissue, then precise tissue cutting can be achieved, but procedural complexity increases
Solution Approach 1:
The patent makes the guidewire multi-functional by combining its traditional navigation function with a cutting function through the addition of the insulation gap and electrical conductivity. This single device performs both guidewire navigation and precise tissue cutting, eliminating the need for separate cutting instruments and reducing procedural complexity.
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 SESAME procedure effectively reduces LVOT obstruction and minimizes bystander tissue injury by precise tissue cutting, enhancing procedural control and safety.
Implementation Method 1
The kink or bend concentrates electrical charge and helps to position the charge-delivery-device at the therapy target to avoid bystander injury
Data Source
AI summary
The disclosure provides various embodiments of systems to facilitate the cutting of tissue structures and other tissue structures percutaneously.