Reentry Catheter Movable Cover True Lumen Access
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Solution Overview
Problem
Current methods for treating chronic total occlusions (CTOs) in coronary artery disease are hindered by the difficulty of re-entering the true lumen after subintimal crossing, often requiring unnecessary trauma and extending subintimal angioplasty or stenting beyond the occluded segment, making successful revascularization challenging and costly.
Innovation Solution
A reentry catheter with a movable cover and J-shaped filler, allowing for precise reentry into the true lumen using an elongate medical device to open the cover and facilitate reentry, reducing trauma and enabling reentry closer to the occlusion site without the need for a needle.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a needle is used for reentry into the true lumen, then reentry can be achieved, but unnecessary trauma is caused to the vessel wall
Solution Approach 1:
The patent removes the needle component from the reentry catheter system entirely. Instead of using a needle to puncture the vessel wall, the invention employs a side-branch catheter that navigates through a natural side branch vessel to reach the true lumen, thereby eliminating the traumatic needle puncture while maintaining reentry capability
Solution Approach 2:
The side branch vessel serves as an intermediary pathway between the subintimal space and the true lumen. By using the natural side branch as a mediator, the catheter can transition from the subintimal plane to the true lumen without direct needle penetration, reducing vessel wall trauma
2Reliability
If subintimal passage is extended to a site significantly remote from the occlusion, then true lumen reentry can be achieved, but subintimal angioplasty or stenting must extend beyond the occluded segment
Solution Approach 1:
The patent performs preliminary identification and access to side branches distal to the occlusion before attempting reentry. By pre-positioning the catheter in the side branch and preparing the reentry mechanism in advance, the system enables reentry at or near the occlusion site rather than requiring extensive subintimal passage, thereby limiting the extent of required angioplasty or stenting
3Reliability
If conventional reentry methods are used, then reentry may be achieved, but the procedure becomes complicated and expensive
Solution Approach 1:
The patent combines the reentry catheter, side branch access system, and reentry mechanism into a single integrated device. This merging of previously separate components (reentry needle, guide catheter, wire) into one unified system simplifies the procedure by reducing the number of separate interventions and manual reconfigurations required, thereby reducing procedural complexity while maintaining reentry capability
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 reentry catheter effectively allows for safer and more precise reentry into the true lumen, reducing trauma and the need for extensive subintimal procedures, thereby improving the success rate and cost-effectiveness of endovascular treatments for CTOs.
Implementation Method 1
a movable cover hingedly attached to the sidewall of the shaft, the movable cover biased in a closed position and configured to occlude the distal side opening when in the closed position
Data Source
AI summary
The disclosure provides apparatus and methods for reentering a true lumen. The reentry catheter includes a shaft that includes a proximal opening in a proximal end of the shaft, a J-shaped filler in a distal end of the shaft, and a distal side opening in a sidewall of the shaft. The distal side opening is adjacent to the J-shaped filler. A passageway extends between the proximal opening and the distal side opening. The proximal opening, the distal side opening, and the passageway each are configured for the passage of an elongate medical device there through. A movable cover is hingedly attached to the sidewall of the shaft biased in a closed position and configured to occlude the distal side opening when in the closed position. The elongate medical device is configured to open the movable cover, the movable cover is configured to facilitate reentry to a true lumen.