Nathan Luibrand Nicholas Luibrand Lukas Richards and Elise AdcockHinojosa Advised by Dr Michael Barnett Problem Statement There is only one tool commonly used today the En Snare Very limited maneuverability ID: 584594
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Intravascular Foreign Body Retrieval System
Nathan Luibrand, Nicholas Luibrand, Lukas Richards, and
Elise Adcock-Hinojosa
Advised by Dr. Michael BarnettSlide2
Problem Statement
There is only one tool commonly used today, the En Snare.
Very limited maneuverability. Slide3
Background
Over 70,000 foreign body retrieval procedures are performed per year.
Items retrieved from the vascular system include wire and catheter fragments and stents.
Unable to retrieve medical statistics for use due to company privacy.
The En Snare Device
A system of 3 interlocked loops of wire which when pulled into the catheter cause the loops to close and catch the targeted foreign body.
Using a wire snare, like the En Snare, is only successful when there is a free floating end to the foreign body
Some foreign bodies are caught at awkward angles and require a better orientation in order to be pulled inside the catheter to reduce damage to the vessels during retrieval.Slide4
Advantages
There are some advantages to using a forcep-like device over using wire snares for foreign object retrieval:
Greater maneuverability (rotational and “grasping” area)
The ability to dislodge a foreign body trapped with no free end: the ability to grab the foreign body in the middle of the object
Less damage to the endothelium or vascular wall when removing sharp dislodged objectsSlide5
How can this tool be used?
The En Snare, as well as any future devices foreign body removal devices can be used in:
Indwelling Venous Catheter Repositioning
An indwelling venous catheter allows for venous access for long periods of time (months to years), and it is more easily repositioned with a retrieval device.
Snare Assisted Guide Wire Capture
When introducing a wire into the body, the use of a snare entered through a different incision can aid in guiding the wire where it needs to go (i.e. capturing a wire over the aortic bifurcation).
http://www.saintfrancis.com/hearthospital/services/heartsurgery.aspxSlide6
How can this tool be used?
Foreign Body Removal
Stents, wires, thrombi, etc.
http://www.mayoclinic.org/cardiothoracicsurgery-jax/diseases.htmlSlide7
Primary Objective
To design a device which can not only “grab” foreign bodies, but which can also manipulate them in such a way as for easier removal.
Construct multiple different prototypes and/or 3D models to represent functionality.Slide8
Performance Criteria
This tool will be used to perform intravascular retrieval from peripheral arterial or venous access sites.
Its size could range from 1-8 mm in diameter and 160-190 cm long.
The goal is to be able to use the tool to reorient and remove debris –both natural and synthetic- from vasculature of small to large radii through a catheter.
Current techniques do not allow for effective reorientation and subsequent alignment with a catheter for retrieval.Slide9
Work Completed
Received funding for materials needed – engineering kit w/ nitinol and supplies for prototype construction.
Establish project specifics pertaining to tool constraints
Gained access to the cath lab and related materials
Created basic concept drawings, and performed literature searches to compare with existing designs.
Completed animations demonstrating basic functionality of device.Slide10
3D Modeling
Titanium head
Nitinol wiring
Platinum lining - imagingSlide11
Current Work
Brainstorming of additional ideas.
Looking for appropriate materials to construct a large-scale En Snare device from.
Demonstrate a mock surgery in the cath lab
Hands-on experience with a variety of tools – potential to translate ideas into our project.
Developing addition 3D models of potential designsSlide12
Future Work
Determination of the best design sketched
Complete construction of a large-scale prototype demonstrating En Snare and other device functionality.
We consider success in the overall academic year to be the completion of an acceptable large-scale model which demonstrates full functionality. We wish to be at a stage where this model appears promising enough for someone else to be willing to take the design to completion should we choose to conclude our work at graduation.