Retroperfusion Catheter for Diffuse Coronary Artery Disease
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Solution Overview
Problem
Conventional revascularization techniques, such as CABG and PTCA, are ineffective for patients with diffuse CAD and refractory angina, and diabetic patients with advanced coronary atherosclerosis, leading to high mortality and morbidity rates, with limited therapeutic options available for 'no-option' patients.
Innovation Solution
The development of devices and systems for minimally invasive procedures that allow for controlled blood perfusion pressure and retroperfusion, enabling anastomosis between veins and arteries without sutures, using catheters with expandable balloons and Y-configuration cannulas to route arterial blood to ischemic tissues, facilitating autoretroperfusion therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional revascularization techniques (CABG or PTCA) are used, then revascularization can be achieved for suitable patients, but the techniques are ineffective for patients with diffuse CAD and refractory angina
Solution Approach 1:
The patent applies retroperfusion by reversing the normal direction of blood flow. Instead of delivering blood forward through blocked coronary arteries, the system withdraws blood from the coronary sinus (venous system) and returns it retrograde through the same or different coronary vessels to reach ischemic myocardial tissue that cannot be accessed by conventional antegrade revascularization methods
Solution Approach 2:
The patent uses an intermediary device system consisting of catheters, pumps, and control mechanisms to facilitate blood flow redirection. The intermediary system includes a withdrawal catheter positioned in the coronary sinus, a return catheter positioned in a coronary artery, and a pump to drive the retrograde flow, enabling treatment of diffuse CAD when direct surgical or percutaneous revascularization is not feasible
2Productivity
If CABG is performed for vessels with diffuse CAD, then revascularization is attempted, but the outcome is relatively poor and mortality risk increases
Solution Approach 1:
The retroperfusion system utilizes the patient's own blood (autologous blood) withdrawn from the coronary sinus and returned to the myocardium. This self-service approach eliminates the need for external blood sources, grafts from other vessels, or complex surgical anastomoses required in CABG, while directly targeting the ischemic tissue through the venous-arterial recirculation pathway
3Manufacturing precision
If conventional revascularization is performed, then focal lesions can be treated, but diffuse disease over large vessel lengths cannot be effectively addressed
Solution Approach 1:
The retroperfusion system serves multiple functions: it can treat diffuse CAD affecting large portions of the myocardium, address refractory angina, and potentially treat multiple vascular territories simultaneously. The system's versatility allows it to handle cases that extend beyond the capabilities of focal revascularization techniques, providing a universal approach for various ischemic cardiac conditions
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
This approach provides a viable treatment option for 'no-option' patients by improving blood flow to ischemic tissues, reducing mortality and morbidity, and offering a minimally invasive alternative to traditional revascularization methods, particularly for those with diffuse CAD and refractory angina.
Implementation Method 1
providing controlled retroperfusion of an artery to a vein distal to an occlusion site in the artery
Implementation Method 2
catheters with expandable balloons and Y-configuration cannulas to route arterial blood to ischemic tissues
Data Source
AI summary
Devices, systems, and methods for providing retroperfusion to at least one ischemic tissue in a minimally invasive manner are disclosed. At least some of the embodiments disclosed herein enable an anastomosis to be formed between a vein and an artery without the use of sutures and through a non-invasive procedure. In addition, various disclosed embodiments provide a cannula device comprising a Y-configuration for bifurcating arterial flow between an anastomosis and the underlying artery. The devices, systems and methods herein can further provide simultaneous autoretroperfusion therapy to more than one area of an ischemic tissue.