Venous Thromboembolism Mitigation Device Using Intermittent Pneumatic Compression
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Solution Overview
Problem
Current treatments for deep vein thrombosis (DVT) are inadequate, as mechanical therapy devices fail to effectively prevent clot formation and systemic anti-coagulation poses a risk of bleeding, especially in hospitalized patients, while the molecular and cellular mechanisms underlying DVT remain poorly understood.
Innovation Solution
The development of venous thromboembolism mitigation devices that generate venous valve oscillatory flow in immobile individuals by using a foot holster, ankle brace, and actuator to mimic the natural oscillatory flow induced by muscular activity, thereby enhancing the expression of anti-thrombotic proteins and preventing DVT formation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Speed
If mechanical therapy devices are used to increase venous blood flow, then venous return is improved, but the ability to prevent clot formation is insufficient
Solution Approach 1:
The patent applies periodic action by using intermittent pneumatic compression that cycles between inflation and deflation phases. The compression is delivered in repeated sequences rather than continuously, creating oscillatory flow patterns that more effectively prevent clot formation while maintaining venous return. This periodic mechanism addresses the limitation of continuous compression devices by mimicking natural muscle contraction rhythms.
Solution Approach 2:
The patent implements dynamics by transitioning from static or continuous compression to dynamic oscillatory compression. The device creates alternating compression and decompression phases that generate bidirectional flow patterns, dynamically adapting the flow regime to better prevent stasis-related thrombosis. This dynamic approach overcomes the insufficiency of steady-state compression mechanisms.
2Reliability
If systemic anti-coagulation is used to prevent DVT, then clot formation is reduced, but bleeding risk increases substantially
Solution Approach 1:
The patent replaces the chemical/pharmacological system of systemic anti-coagulation with a mechanical system of localized pneumatic compression. Instead of using drugs that systemically reduce clotting throughout the body (which causes bleeding risks), the device uses mechanical compression forces applied locally to the limbs to prevent clot formation through flow enhancement, thereby avoiding the bleeding side effects of anti-coagulants.
Solution Approach 2:
The patent introduces an intermediary mechanical compression system between the patient's body and the clot prevention goal. Rather than directly interfering with the coagulation system through drugs, the device uses pneumatic compression as an intermediary mechanism to prevent thrombosis through hemodynamic changes, avoiding direct interaction with the coagulation cascade and its associated bleeding risks.
3Speed
If continuous compression is applied to increase venous return, then blood flow is improved, but oscillatory flow patterns needed for DVT prevention are not generated
Solution Approach 1:
The patent applies periodic action by using intermittent pneumatic compression that cycles between inflation and deflation phases. The compression is delivered in repeated sequences rather than continuously, creating oscillatory flow patterns that more effectively prevent clot formation while maintaining venous return. This periodic mechanism addresses the limitation of continuous compression devices by mimicking natural muscle contraction rhythms.
Solution Approach 2:
The patent implements dynamics by transitioning from static or continuous compression to dynamic oscillatory compression. The device creates alternating compression and decompression phases that generate bidirectional flow patterns, dynamically adapting the flow regime to better prevent stasis-related thrombosis. This dynamic approach overcomes the insufficiency of steady-state compression mechanisms.
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
These devices effectively stimulate the expression of anti-thrombotic proteins in venous valve sinuses, reducing the risk of DVT formation and providing a safer alternative to systemic anti-coagulation by mimicking natural muscular activity-induced flow patterns.
Implementation Method 1
These devices effectively stimulate the expression of anti-thrombotic proteins in venous valve sinuses by mimicking natural muscular activity-induced flow patterns
Implementation Method 2
The development of venous thromboembolism mitigation devices that generate venous valve oscillatory flow in immobile individuals by using a foot holster, ankle brace, and actuator to mimic the natural oscillatory flow induced by muscular activity
Data Source
AI summary
The presently disclosed subject matter provides a mechanism in which DVTs form when reduced muscular activity results in loss of oscillatory shear-dependent transcriptional and ant-thrombotic phenotypes in peri-valvular venous endothelial cells. Endothelial cells surrounding the venous valve, where DVTs originate, experience oscillatory shear forces in response to muscular activity. Peri-valvular venous endothelial cells express high levels of FOXC2 and PROX1, transcription factors known to be activated by oscillatory shear stress, exhibit an anti-thrombotic phenotype characterized by low levels of the procoagulant proteins von Willebrands Factor (vWF), P-selectin and intercellular adhesion molecule 1 (ICAM1), high levels of the anticoagulant proteins thrombomodulin (THBD), endothelial protein C receptor (EPCR) and tissue factor pathway inhibitor (TFPI), and resistance to thrombin-induced clot formation. The peri-valvular venous anti-thrombotic endothelial phenotype is lost following femoral artery ligation that reduces venous flow or genetic loss of FOXC2 or PROX1 in mice, and at the site of human DVT associated with lethal PE.