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 Coat prongs of filter
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 Item Description Amount Needed Price Price/Instrument Surgicel
Matrix for platelet adhesion
''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
2 m, 1mm diameter
Basket
Titanium
150 mm, 0.1mm
27/25ft
0.54
Raw Material Cost
29.65

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