Endovascular Splanchnic Nerve Ablation for Heart Failure
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Solution Overview
Problem
Current therapies for heart failure, particularly for patients with diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF), are inadequate, leading to recurrent acute decompensated heart failure episodes and significant healthcare costs, with a lack of effective management strategies beyond classical paradigms focusing on salt and fluid retention.
Innovation Solution
The method involves ablating the thoracic splanchnic nerve or its roots to increase splanchnic capacitance, using a medical device positioned intravascularly to create lesions in the thoracic splanchnic nerves, thereby treating hypertension and heart failure by reducing blood volume in the splanchnic bed.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If current therapies for heart failure are used, then heart failure management is provided, but the therapies are inadequate leading to recurrent acute decompensated heart failure episodes and significant healthcare costs
Solution Approach 1:
The patent extracts and removes the splanchnic nerve from functional operation through ablation. By destroying this specific nerve pathway, the invention eliminates the mechanism causing excessive splanchnic blood volume retention, thereby preventing recurrent heart failure episodes without affecting other bodily functions
Solution Approach 2:
The invention changes the physiological parameter of splanchnic capacitance by ablating the splanchnic nerve. This parameter change reduces splanchnic blood volume and improves cardiac function, providing a new therapeutic approach for heart failure with preserved ejection fraction that addresses the inadequacy of current therapies
2Reliability
If splanchnic nerve ablation is performed to increase splanchnic capacitance, then blood volume in the splanchnic bed is reduced, but the procedure requires intravascular positioning and lesion creation
Solution Approach 1:
The patent uses an intravascular device as an intermediary to deliver ablation energy to the splanchnic nerve. The device positions ablation elements within blood vessels near the nerve, using the vasculature as a delivery pathway to reach the target nerve without direct external access, thereby simplifying the overall procedure
Solution Approach 2:
The invention replaces traditional mechanical nerve block or surgical approaches with energy-based ablation. By using thermal or other forms of energy delivered through the intravascular device, the procedure achieves nerve destruction without complex mechanical dissection or positioning, reducing procedural complexity
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 effectively reduces the workload on the heart by decreasing the volume of blood returned to the heart, potentially alleviating symptoms of heart failure and reducing healthcare costs associated with recurrent admissions.
Implementation Method 1
ablating the thoracic splanchnic nerve or its roots to increase splanchnic capacitance, using a medical device positioned intravascularly to create lesions in the thoracic splanchnic nerves
Data Source
AI summary
Systems, devices, and methods for transvascular ablation of target tissue. 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.