Tracheal Nerve Ablation with Esophageal Cooling Protection
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Solution Overview
Problem
Current pulmonary ablation procedures face challenges in avoiding injury to the esophagus and branches of the vagus nerve during treatments, particularly due to the risks of esophageal injury observed in cardiac ablation therapies, which can lead to complications such as esophageal fistulae and acute pyloric spasm.
Innovation Solution
The development of devices and methods that include an elongate member with energy delivery elements for targeting nerve tissue in the trachea while protecting the esophagus and vagus nerve branches, using cooling mechanisms to prevent tissue damage and positioning energy delivery elements to minimize overlap with non-target tissues, allowing for precise ablation of nerve tissue without harming adjacent tissues.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If energy delivery elements are positioned close to the esophagus to treat pulmonary nerve tissue, then treatment effectiveness is improved, but the risk of esophageal injury increases
Solution Approach 1:
A cooling catheter is introduced as an intermediary device between the energy delivery element and the esophagus. The cooling catheter delivers cold saline or other cooling media to create a protective thermal barrier, allowing energy delivery close to the esophagus while preventing thermal injury to esophageal tissue.
Solution Approach 2:
Cooling media are delivered in advance before energy delivery to pre-cool the esophageal tissue. This preliminary cooling action creates a protective effect that counteracts the potential harmful thermal effects of subsequent energy delivery, enabling safer treatment near the esophagus.
2Power
If ablation energy is increased to improve treatment efficacy, then nerve tissue destruction is more effective, but damage to adjacent non-target tissues increases
Solution Approach 1:
The harmful thermal energy that could damage adjacent tissues is converted into a beneficial protective mechanism through active cooling. The cooling system uses the thermal energy dissipation to create a controlled thermal gradient, where the cooling media absorb excess heat and protect non-target tissues while allowing high-power ablation of the target nerve tissue.
Solution Approach 2:
Different thermal conditions are applied to different regions: high temperature ablation is concentrated on the target pulmonary nerve tissue, while the esophageal and adjacent tissues are maintained at lower temperatures through localized cooling. This spatial differentiation of thermal quality allows effective treatment without collateral damage.
3Area of stationary object
If the treatment area is expanded to cover more pulmonary nerve tissue, then treatment coverage is improved, but the risk of injuring non-target structures increases
Solution Approach 1:
The cooling catheter serves as a protective intermediary that can be positioned to cover extended areas adjacent to the treatment zone. As the treatment area is expanded, additional cooling segments or extended cooling catheters can be deployed to maintain protective coverage over a larger region, allowing safe expansion of the treatment footprint.
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 risk of esophageal injury during pulmonary ablation procedures, enabling targeted treatment of pulmonary diseases like asthma and COPD while maintaining the functionality of the airway and preserving respiratory functions.
Implementation Method 1
Cooling media can be delivered to the airway wall to prevent or reduce tissue damage
Implementation Method 2
Energy can be delivered from the element to a portion of the circumference of the airway to create lesions and alter nerve tissue
Data Source
AI summary
Devices and methods for treating one or more pulmonary diseases while avoiding or minimizing injury to the esophagus and branches of the vagus nerve that run along the outside of the esophagus. The device includes at least one energy delivery element disposed on an elongate member and a means for protecting the esophagus and surrounding tissues, such as esophageal branches of the vagus nerve, during treatment. The energy delivery element is positionable to target at least one nerve in or around the tracheal wall when the elongate member is positioned in the trachea. Energy from the energy delivery element is delivered to the at least one nerve to treat pulmonary symptoms, conditions, and/or diseases, such as asthma, COPD, obstructive lung diseases, or other pulmonary diseases, while the protection means protects the esophagus and surrounding tissues from permanent damage.