Chronic Total Occlusions (CTOs) are currently the last frontier for cardiovascular surgery. CTOs are defined as heavily calcified occlusions in the vascular system of the heart that slowly form over time and are at least three months old. The preferred treatment option of CTOs is a so-called Percutaneous Coronary Intervention (PCI). Unfortunately, in many occasions PCI is ineffective as the guidewire is not able to cross the CTO due to lack of stiffness of the guidewire and the less than favourable properties of the CTO. Therefore, the success rate of these kinds of interventions is relatively low, which in turn has led to the tendency to treat these kinds of lesions medically.
To improve the success rate of these kinds of interventions it is, therefore, necessary to develop a new tool that is able to cross the CTO without buckling. From this, the idea arose to use shockwaves to puncture through CTOs. Shockwaves are used in the animal kingdom to strike through hard shells and prey capture by, for example, the Mantis Shrimp. They are particularly effective in fluidic environment such as the blood vessels and are, therefore, a good candidate for prototype development.
This research project will entail a literature study where the use of shockwaves in the animal kingdom and other shockwave applications and/or instruments is investigated, and a graduation project where innovative shockwave tool for puncturing the proximal cap of chronic total occlusions is developed.
Contact: Aimée Sakes, firstname.lastname@example.org