Pulmonary Embolism Extraction Catheter Development

Trip CothrenLauren NicholsDustin Temple

Advised by: Dr. Michael Barnett, VUMC Cardiology

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?

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

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

Our Design Combined ideas from multiple existing

medical products• Inferior vena cava filter• Absorbable hemostat• Local clot busting drug administration

Security from multiple backups

Filter Based off inferior vena

cava filter Umbrella-like device Expandable to various

sizes Combined to reduce

stress on vessel wall

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

Trellis Catheter Device Inflatable back-end

“clot-catching” device

Local drug delivery

Use of guide wire

Preliminary CAD

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

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

Cost of Comparison Devices Trellis Device

• $2095 for complete device AngioJet

• $38,000 for drive unit• $650 - $2050 for disposables (catheters)

Price

Item Description Amount Needed Price Price/Instrument

SurgicelMatrix for platelet adhesion 1 - 0.5''x2'' piece 273.4/piece 22.78

Guidewire Stainless Steel Wire 2 m, 0.75mm diameter 13.99/300in 3.73

Catheter Sheath Silicon Tube 2 m, 2mm diameter 0.2/ft 1.3

Drug Eluting Sheath Silicon Tube 2 m, 1mm diameter 0.2/ft 1.3

Basket Titanium 150 mm, 0.1mm 27/25ft 0.54

Raw Material Cost 29.65

Potential Problems Hemolysis causes release of adenosine

when cells lyse Bradycardia or heart failure Renal failure Unpredictable thrombolytic tolerance Mechanical damage to vessel wall

Future Work

Refine model using Pro Engineer or AutoCAD

Further work with prototype

DesignSafe

References http://www.medgadget.com/archives/img

/sidcath.jpg http://www.socalcardiology.com/media/a

ngiojet.jpg http://www.lexmed.com/images/

cathphoto2.jpg