Renal Nerve Stimulation Guidance Using Blood Flow and Pressure Response
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Solution Overview
Problem
Renal denervation procedures are not effective for all patients or locations within the renal vasculature, making it difficult for physicians to determine suitability, leading to unsuccessful procedures and wastage of resources.
Innovation Solution
An endovascular device with electrodes for nerve stimulation and sensors for blood flow and pressure measurement, coupled with a processor circuit to analyze hemodynamic responses, determines the effectiveness of renal denervation by comparing stimulated and baseline data.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If renal denervation procedure is performed without predictive testing, then the procedure can be performed quickly, but the effectiveness is uncertain and may be wasted
Solution Approach 1:
The system performs preliminary nerve stimulation and hemodynamic measurement before the actual denervation procedure to predict treatment effectiveness. By conducting this predictive testing in advance, physicians can identify suitable candidates and optimize treatment parameters before committing to the full procedure, thereby improving reliability while minimizing time loss.
Solution Approach 2:
The system continuously monitors hemodynamic parameters (blood pressure, heart rate, renal blood flow) during and after nerve stimulation to provide real-time feedback on treatment response. This feedback mechanism allows dynamic adjustment of stimulation parameters and enables prediction of long-term treatment effectiveness based on acute responses.
2Measurement precision
If renal denervation is performed at incorrect locations, then the procedure can be completed, but the treatment effectiveness is reduced
Solution Approach 1:
The system replaces complex mechanical imaging and anatomical mapping with electrical stimulation and hemodynamic measurement. By using electrical signals to activate nerves and monitoring blood flow changes, the system precisely identifies target locations without requiring complex mechanical guidance systems, thereby improving accuracy while reducing device complexity.
Solution Approach 2:
The system changes the parameters for identifying target locations from anatomical coordinates to functional responses. By measuring changes in blood pressure, heart rate, and renal blood flow during nerve stimulation, the system dynamically identifies the most effective treatment locations based on physiological response rather than static anatomical markers.
3Productivity
If multiple patients undergo renal denervation without predictive testing, then more treatments can be performed, but resource wastage increases
Solution Approach 1:
The system provides immediate feedback on treatment effectiveness through hemodynamic monitoring during predictive testing. By measuring changes in blood pressure, heart rate, and renal blood flow response to nerve stimulation, the system can quickly identify non-responders and avoid performing unnecessary denervation procedures, thereby reducing resource wastage while maintaining high productivity.
Solution Approach 2:
The system performs preliminary predictive testing on all patients before proceeding to denervation surgery. This advance screening identifies suitable candidates and optimizes treatment parameters, ensuring that only patients with high likelihood of response undergo the full procedure, thereby reducing resource consumption while maintaining high treatment throughput.
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 system helps identify suitable candidates for renal denervation and assess procedure success, reducing unnecessary procedures and resource wastage by providing data-driven decision-making.
Implementation Method 1
a flow sensor for measuring blood velocity
Implementation Method 2
a pressure sensor for measuring pressure
Implementation Method 3
the electrodes of the device emit electrical energy for a period of time, stimulating the surrounding renal nerves
Implementation Method 4
The device includes electrodes which may both stimulate surrounding renal nerves and ablate renal nerves
Data Source
AI summary
A system includes a processor circuit configured to receive an endovascular flow measurement obtained by an endovascular flow measurement positioned within a blood vessel of a patient. The system controls a nerve stimulation device to stimulate a nerve of the patient and receives an additional endovascular flow measurement while the nerve is stimulated. The processor circuit then performs a comparison of the two flow measurements received and provides an output based on the comparison.