Renal Access and Capsular Drainage for Pressure Reduction
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Solution Overview
Problem
There is a need for safe and effective methods to reduce renal pressures and interstitial fluid accumulation in patients with heart failure and other cardiac and kidney conditions, as increased renal parenchymal pressure can lead to renal dysfunction and complications such as ADHF, CKD, AKI, and hypertension, which are often exacerbated by the compression of renal structures and the activation of the Renin-Angiotensin-Aldosterone System.
Innovation Solution
The methods and devices involve accessing the renal capsule to reduce pressures by draining fluid, modifying surrounding tissues through decapsulation, perforation, scoring, or tissue weakening, and using energy or mechanical means to create an alternative drainage pathway, with the use of stents, grommets, and implants to maintain patency and prevent regrowth, and employing minimally invasive techniques to reduce renal interstitial pressures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the renal capsule is intact and non-compliant, then structural integrity and protection are maintained, but renal parenchymal pressure increases and renal function deteriorates
Solution Approach 1:
The renal capsule is divided into multiple segments through incisions or perforations, allowing localized pressure relief while maintaining overall structural integrity. This segmentation enables the capsule to accommodate volume changes without causing widespread compression of renal structures.
Solution Approach 2:
Fluid and interstitial material are extracted from the perirenal space and subcapsular region through drainage catheters and puncture sites. This extraction reduces the volume within the constrained capsule, thereby reducing parenchymal pressure and improving renal function.
2Quantity of substance
If fluid volume within the renal capsule is increased, then renal interstitial pressure increases, but the non-compliant capsule prevents expansion, leading to compression of renal structures
Solution Approach 1:
Excess fluid is removed from the perirenal and subcapsular spaces through drainage catheters and puncture sites, reducing the volume that compresses the renal capsule and its embedded structures.
Solution Approach 2:
The problem is addressed by creating a subcapsular space between the capsule and parenchyma, providing an additional dimension for fluid accumulation and pressure relief. This allows volume increase without direct compression of renal structures.
3Reliability
If decapsulation or tissue modification is performed, then renal pressure is reduced and function is improved, but procedural complexity and risk increase
Solution Approach 1:
Instead of complete decapsulation, partial capsular incisions or perforations are performed to achieve sufficient pressure relief. This partial action reduces the complexity and risk of the procedure while maintaining the therapeutic effect of pressure reduction.
Solution Approach 2:
Drainage catheters and puncture sites serve as intermediaries to facilitate fluid removal and pressure relief without requiring direct manipulation or complete removal of the capsule. This intermediary approach simplifies the procedure while achieving the therapeutic goal.
Data Source
AI summary
Systems and methods for renal access and pressure reduction. In one or more embodiments, there are provided various systems and methods to reduce renal pressures. In one or more aspects, there are provided devices and methods for the removal or reduction of a capsular constriction to reduce renal pressures such as by one or more of removing fluid or tissue.