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Pulmonary Embolism Extraction Catheter Development

Develop a catheter to remove pulmonary embolisms in hospitals, reducing the risks associated with systemic thrombolytics. Our design combines existing medical products to create a feasible prototype.

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Pulmonary Embolism Extraction Catheter Development

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  1. Pulmonary Embolism Extraction Catheter Development Trip Cothren Lauren Nichols Dustin Temple Advised by: Dr. Michael Barnett, VUMC Cardiology

  2. Problem • There are over 600,000 cases of pulmonary embolisms annually in the United States, which result in nearly 60,000 fatalities. • Systemic thrombolytics can be dangerous • Is there a catheter solution that can quickly remove PE in the hospital setting?

  3. Thrombolytics • Medicine used to dissolve blood clots • Risk of bleeding in other organs • Vascular injury at injection site • Great risk of stroke in the elderly • Elderly is our target population

  4. Goals • The goal of this project is to design a catheter that can efficiently remove an embolism from the pulmonary artery. The main goals of the project are: • To research and evaluate current technology in pulmonary embolism extraction • To design a catheter that can successfully remove embolisms percutaneously and completely without damage to the patient • To produce a feasible prototype of our design

  5. Our Design • Combined ideas from multiple existing medical products • Inferior vena cava filter • Absorbable hemostat • Local clot busting drug administration • Security from multiple backups

  6. Filter • Based off inferior vena cava filter • Umbrella-like device • Expandable to various sizes • Combined to reduce stress on vessel wall

  7. Surgicel or Gelita • Material that attracts clots • Oxidized cellulose polymer • Used clinically for over 50 years • Coat prongs of filter • Prevent clots pieces from going downstream • Made by Ethicon

  8. Trellis Catheter Device • Inflatable back-end “clot-catching” device • Local drug delivery • Use of guide wire

  9. Preliminary CAD

  10. Design • Length of 2m • Stainless steel guidewire diameter of 0.75mm • Silicone sheath • Outermost diameter of 6F (2mm) • Titanium basket • Surgicel coated on basket prongs

  11. Procedure • Clot localized with x-ray angiography • Catheter inserted through femoral vein • Procedure time less than 1 hour • Basket device pushed through clot, then sheath removed and basket expanded • tPA locally administered and catheter pulled back out with clot pieces attached

  12. Cost of Comparison Devices • Trellis Device • $2095 for complete device • AngioJet • $38,000 for drive unit • $650 - $2050 for disposables (catheters)

  13. Price

  14. Potential Problems • Hemolysis causes release of adenosine when cells lyse • Bradycardia or heart failure • Renal failure • Unpredictable thrombolytic tolerance • Mechanical damage to vessel wall

  15. Future Work • Refine model using Pro Engineer or AutoCAD • Further work with prototype • DesignSafe

  16. References • http://www.medgadget.com/archives/img/sidcath.jpg • http://www.socalcardiology.com/media/angiojet.jpg • http://www.lexmed.com/images/cathphoto2.jpg

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