Endovascular Splanchnic Nerve Ablation for Heart Failure Decongestion
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Solution Overview
Problem
Current therapies for heart failure, particularly diastolic dysfunction and HFpEF, are inadequate, leading to recurrent acute decompensated heart failure episodes and significant healthcare resource utilization.
Innovation Solution
Ablation of thoracic splanchnic nerves or nerve roots using an intravascular medical device to increase splanchnic capacitance, thereby treating hypertension and heart failure by creating lesions in the vicinity of target tissues within vessels such as the azygous and intercostal veins.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If current therapies for heart failure are used, then patients receive standard treatment, but they experience recurrent acute decompensated heart failure episodes and significant healthcare resource utilization
Solution Approach 1:
The patent extracts and removes the splanchnic nerve from its normal functional state through ablation, eliminating its harmful effect of excessive sympathetic tone that contributes to heart failure pathophysiology. The ablation catheter delivers energy to destroy the nerve tissue, effectively taking out the problematic neural pathway that drives splanchnic vasoconstriction and fluid retention.
Solution Approach 2:
The patent replaces conventional pharmacological therapy with a procedural intervention using an ablation catheter. Instead of using drugs to manage heart failure symptoms, the invention uses thermal or other forms of energy delivery to physically ablate the splanchnic nerve, substituting a mechanical/energy-based system for the pharmacological approach.
2Reliability
If splanchnic nerve ablation is performed to increase splanchnic capacitance, then heart failure symptoms are reduced, but the procedure requires intravascular device placement and energy delivery
Solution Approach 1:
The ablation catheter is designed to perform multiple functions: navigation through the venous system, positioning at the target splanchnic nerve location, delivery of ablation energy, and potentially verification of nerve ablation. This multi-functional device consolidates what could be multiple separate procedures into a single integrated intervention.
Solution Approach 2:
The ablation catheter serves as an intermediary tool that bridges the gap between the operator and the target splanchnic nerve. It delivers the ablation energy indirectly through its ablation element, allowing precise energy delivery to the nerve without direct surgical exposure or complex dissection.
3Productivity
If ablation energy is delivered to create lesions in target tissue, then splanchnic venous blood return is reduced, but energy must be delivered through intravascular positioning
Solution Approach 1:
The catheter design allows the ablation element to self-position or self-align with the target tissue through its interaction with the vessel wall. The ablation element may be configured to automatically contact the vessel wall at the appropriate location, reducing the need for complex manual positioning and enhancing ease of operation.
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 method effectively reduces splanchnic venous blood return, providing a therapeutic benefit for heart failure patients by increasing splanchnic capacitance and reducing symptoms of heart failure.
Implementation Method 1
delivering ablation energy from the medical device to create a lesion in tissue surrounding the first vessel
Implementation Method 2
ablating one or more of a patient's preganglionic thoracic splanchnic nerves or thoracic splanchnic nerve branches to increase splanchnic capacitance
Data Source
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AI summary
Systems, devices, and methods for transvascular ablation of target tissue are disclosed herein. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are method of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.