Shockwaves for Puncturing through Occlusions (Closed)

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, a.sakes@tudelft.nl

Design of A Flexible Tissue Removal Device for Skull Base Surgery

Cushing’s disease is a neurological disorder caused by the loss of dopamine secretion in and near the pituitary gland. Unlike in human Cushing’s disease, where surgical removal of the pituitary tumors is a common treatment modality, in horses oral treatment is the treatment of choice. This oral treatment does not provide a long-term solution to the disease, as it is focused on symptom reduction and does nothing to fight the actual cause of the disease.

In collaboration with the department of Veterinary medicine Utrecht, a new paradigm of surgical treatment of Cushing’s disease in horses has been developed that uses the vascular system in combination with an innovative flexible morcellator to reach the pituitary gland. This flexible morcellator incorporates a rigid tip with a resection tool and a flexible shaft, which incorporates a cable drive element, used for actuating the resection tool, and a central tissue transportation lumen.

Further development of this device is necessary before clinical use can commence. Redevelopment should focus on miniaturisation, improving the cutting blade design, and adding a means of visualizing the pituitary tumors.

We are currently also exploring the possibility to redesign this instrument for human surgery.

Contact: Aimée Sakes, a.sakes@tudelft.nl