Transvascular Phrenic Nerve Stimulation Through Blood Vessel Walls
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Solution Overview
Problem
Existing methods for nerve stimulation, such as phrenic nerve pacing and laproscopic diaphragm pacing, require invasive surgery and are not suitable for ICU patients, while intravascular nerve stimulation methods lack cost-effective and minimally invasive apparatus for facilitating natural breathing and weaning from mechanical ventilation.
Innovation Solution
Intravascular electrodes and electrode structures positioned in blood vessels near target nerves to stimulate them through the vessel walls, using flexible support members and insulating pads to maintain electrode position and reduce electrical contact with blood, allowing for minimally invasive nerve stimulation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional phrenic nerve pacing electrodes are implanted directly in or near the nerves, then effective nerve stimulation is achieved, but invasive surgery is required which is risky and complicated
Solution Approach 1:
The patent uses the blood vessel wall as an intermediary medium to deliver electrical stimulation to the phrenic nerve. Instead of placing electrodes directly on the nerve, the electrodes are positioned in the blood vessel adjacent to the nerve, and electrical current is transmitted through the vessel wall to stimulate the nerve. This intermediary approach eliminates the need for direct nerve exposure and complex surgical dissection while maintaining effective stimulation.
Solution Approach 2:
The patent replaces the mechanical surgical approach of direct nerve electrode implantation with a less invasive method using blood vessel access. The catheter-based delivery system substitutes for traditional open or laparoscopic surgery, reducing surgical complexity and risk while achieving the same therapeutic goal of phrenic nerve stimulation.
2Reliability
If invasive surgical methods are used for nerve stimulation, then effective breathing control is achieved, but patient mobility and quality of life are reduced
Solution Approach 1:
The blood vessel serves as an accessible intermediary that allows delivery of the stimulation device without requiring chest wall incisions or complex thoracic surgery. The percutaneous catheter approach uses existing vascular access routes, enabling patients to maintain normal mobility and activities while receiving effective diaphragm pacing therapy.
3Reliability
If mechanical ventilation is used to support breathing, then life-saving respiratory support is provided, but diaphragm muscle atrophy occurs rapidly
Solution Approach 1:
The patent implements periodic electrical stimulation of the phrenic nerve to induce rhythmic diaphragm contractions. This periodic activation mimics natural breathing patterns and prevents muscle atrophy by maintaining muscle tone and function. The stimulation can be applied intermittently or continuously at physiological frequencies to keep the diaphragm active while the patient receives respiratory support.
4Ease of operation
If intravascular electrodes are used for nerve stimulation, then minimally invasive approach is achieved, but precise electrode positioning near target nerves is difficult
Solution Approach 1:
The patent incorporates feedback mechanisms to guide electrode positioning within the blood vessel. Electrical impedance measurements, fluoroscopic imaging, or other sensing modalities provide real-time feedback on electrode location relative to the target nerve. This feedback allows operators to adjust electrode position to achieve optimal stimulation while maintaining the minimally invasive catheter-based approach.
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
Enables natural breathing by stimulating phrenic nerves without invasive surgery, reducing muscle atrophy and the risk of complications, and facilitating weaning from mechanical ventilation with lower current requirements and improved selectivity for target nerves.
Implementation Method 1
delivering current to a target nerve through a wall of a blood vessel
Data Source
Figure 1A
Figure 2A~2D
Figure 3A~3C
AI summary
A nerve stimulation system includes a catheter including at least one lumen, an electrode assembly including a plurality of electrodes, a metal ribbon, and an insulative layer. At least a portion of the plurality of electrodes is configured for stimulating a phrenic nerve. An aperture of the insulative layer includes metal and the metal connects the metal ribbon to at least one electrode of the plurality of electrodes.