Transient Occlusion Device for Intracerebral Hemorrhage Control
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Solution Overview
Problem
Current treatments for hemorrhagic strokes, particularly those caused by bleeding in small penetrating vessels like the Lenticulostriate Arteries, are invasive and lack effective non-surgical solutions, often risking additional ischemic strokes due to full occlusion of parent arteries.
Innovation Solution
A catheter-based system for transient occlusion of bleeding vessels, reducing blood flow by 50-70% to prevent further bleeding, while maintaining flow in the parent artery to avoid ischemia, using devices like balloons, mesh structures, and occlusive materials to seal hemorrhaging ostia and trigger coagulation for hemostasis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If full occlusion of the parent artery (MCA) is performed to achieve hemostasis in hemorrhaging perforating vessels, then bleeding is stopped, but ischemia is caused downstream creating an additional ischemic stroke
Solution Approach 1:
The patent applies local quality by using a flow diverter device with selectively positionable arms that can occlude only the specific hemorrhaging perforating vessel ostia while leaving the rest of the parent artery patent. The device allows targeted intervention at the bleeding site without affecting downstream blood flow to other territories, thus achieving hemostasis while preventing ischemic complications.
Solution Approach 2:
The flow diverter device is segmented into multiple independently positionable arms or elements that can be selectively deployed to occlude individual perforating vessel ostia. This segmentation allows precise control over which vessels are occluded, enabling treatment of specific hemorrhaging vessels while maintaining flow through the parent artery to other brain regions.
2Reliability
If no intervention is performed on hemorrhaging perforating vessels, then blood flow is maintained, but hemorrhage continues expanding causing increased brain damage
Solution Approach 1:
The device provides localized occlusion at the ostia of hemorrhaging perforating vessels while maintaining patency of the parent artery. This selective approach addresses the harmful hemorrhage expansion at the specific bleeding site without compromising overall blood flow maintenance in the parent vessel and its other branches.
3Ease of operation
If catheter-based endovascular approach is used to access small penetrating vessels, then minimally invasive treatment is achieved, but the small and variable anatomy of vessels like LSA makes direct access nearly impossible
Solution Approach 1:
The patent uses the parent artery (MCA) as an intermediary access route to reach the hemorrhaging perforating vessels. Instead of attempting direct access to the small and difficult-to-reach LSA vessels, the device is delivered through the larger, more accessible parent artery and then selectively positioned to occlude the specific perforating vessel ostia from within the parent vessel lumen.
Solution Approach 2:
The approach transitions from trying to access the target vessels from their distal endpoints (which is difficult due to small size and variable anatomy) to accessing them from their proximal ostia within the parent artery. This dimensional change in access strategy allows the use of standard catheter-based delivery systems to reach vessels that would otherwise be inaccessible.
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 effectively reduces hematoma growth and bleeding by minimizing blood pressure on the affected area, promoting thrombosis to seal the vessels without causing ischemia, allowing for potential partial perfusion to prevent iatrogenic ischemia.
Implementation Method 1
This leads to a reduction of blood flow and causing flow to become stagnant, which triggers a coagulation cascade leading to thrombosis that seals the bleeding vessels
Implementation Method 2
The temporary occlusion also effectively reduces the mechanical blood pressure forces acting at the site of arterial rupture and thereby less pressure drives blood into brain tissue
Data Source
AI summary
A method for the hemostasis of perforating and bleeding vessel related to intracerebral hemorrhage (ICH) includes navigating an occlusion device into a parent artery and then deploying the occlusive device to transiently occlude bleeding vessels to reduce blood flow and local blood pressure until hemostasis is achieved, while maintaining flow within the parent artery. Embodiments of the occlusion device include a catheter, an expandable member sized for insertion into the mid-cerebral artery (MCA) and having a length sufficient to occlude at least one ostia of the lenticulostriate arteries (LSA), with a flow path for blood provided from a proximal side of the expandable member to a distal side of the expandable member, and a semi-permeable contacting member about the expandable member and adapted to be in contact with a wall of the MCA adjacent the ostia, the semi-permeable member permitting a reduce flow of blood through the ostia.