Modulated Oxygen Perfusion Catheter for Reoxygenation Injury Mitigation
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Solution Overview
Problem
Current methods for percutaneous coronary interventions fail to effectively prevent reoxygenation injury during the reestablishment of blood flow to ischemic tissues, which can lead to further tissue damage and oxidative stress due to abrupt exposure to oxygen.
Innovation Solution
A method involving the administration of a modulated oxygen content fluid during and after re-opening an occluded blood vessel, where the oxygen concentration is gradually increased over time to avoid hyperoxygenation, using a catheter with an infusion lumen connected to a system that provides a perfusate with controlled oxygen levels, allowing for precise management of oxygen partial pressure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Use of energy by moving object
If normal blood flow is reestablished immediately after PCI procedure, then oxygen delivery to ischemic tissue is improved, but reoxygenation injury and oxidative stress occur due to abrupt oxygen exposure
Solution Approach 1:
The catheter is positioned and prepared for controlled oxygen delivery before the PCI procedure is completed. The system pre-establishes the capability to deliver modulated oxygen content fluid, allowing gradual oxygen reintroduction rather than abrupt exposure when normal blood flow is restored.
Solution Approach 2:
The oxygen content of the perfusate is dynamically modulated during the procedure. The system changes the oxygen concentration parameter from low to high gradually, matching the tissue's progressive ability to tolerate oxygen. This involves adjusting the oxygen content in the fluid delivered through the catheter's infusion lumen based on procedural stage and tissue response.
2Use of energy by moving object
If high oxygen content fluid is administered during PCI, then oxygen supply to ischemic tissue is enhanced, but oxidative stress and tissue damage increase due to hyperoxygenation
Solution Approach 1:
The oxygen content of the administered fluid is made dynamic rather than static. The system adjusts oxygen concentration in real-time based on the procedural phase and tissue tolerance. This involves transitioning from low oxygen content fluid during balloon inflation to gradually increasing oxygen content as the procedure progresses, preventing both hypoxia and hyperoxia.
Solution Approach 2:
The system incorporates monitoring of tissue oxygenation status and adjusts fluid oxygen content accordingly. By observing tissue response and oxygenation levels, the system modulates the oxygen content of subsequent fluid deliveries, creating a feedback loop that prevents oxidative stress while maintaining adequate oxygen supply.
3Speed
If rapid reperfusion is performed after occlusion, then blood flow restoration is accelerated, but inflammatory response and tissue injury are exacerbated
Solution Approach 1:
Controlled perfusion with modulated oxygen content fluid is initiated before complete reperfusion occurs. This preliminary controlled delivery prepares the tissue for upcoming high-flow reperfusion by gradually introducing oxygen and activating protective mechanisms, thereby reducing the inflammatory response when full blood flow is restored.
Solution Approach 2:
The modulated oxygen content fluid acts as a cushioning agent during the transition from ischemia to reperfusion. By delivering fluid with controlled oxygen content, the system buffers the tissue against the abrupt oxidative and inflammatory stress of rapid reperfusion, similar to how a cushion protects against impact.
Data Source
AI summary
A system and methods are described for improving the management of ischemic cardiac tissue during acute coronary syndromes. The system combines a catheter-based sub-system which allows for simultaneous balloon dilation of a coronary artery and infusion of a carefully controlled perfusate during percutaneous coronary intervention. The system allows for modulation of levels of oxygen at the time of percutaneous intervention. In addition, catheters and systems are provided for administration of fluids with modified oxygen content during an intervention that incorporate upstream flow control members to compartmentalize the perfusion of the target coronary artery and the remainder of the heart.