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Specialized balloon for the treatment of chronic total vascular occlusions

Detailed Technology Description

None

*Abstract

BackgroundChronic total occlusions (CTOs) represent an advanced stage of an atherosclerotic lesion in a coronary or peripheral artery, usually resulting from gradual progression of atherosclerotic plaque. By definition, these are occlusions more than 3 months old. Unlike acute arterial thrombotic occlusions that have usually a dramatic clinical presentation, these lesions have a more gradual progression due to simultaneous development of collateral circulation in the territory supplied by the respective artery. When the collateralization is insufficient or the occlusion becomes complete, ischemic symptoms develop.In the coronary arena, it is estimated that up to 30% of the lesions present on diagnostic catheterizations in patients with coronary artery disease (CAD) fall in the CTO category. Revascularization is indicated in the presence of anginal symptoms or evidence of significant ischemia by functional testing. It is important to point out that long term follow up data indicate that revascularization for coronary total occlusion may even offer a survival benefit in these patients, which is thought not to be the case for percutaneous coronary intervention (PCI) of lesion of lesser magnitude. These lesions however present significant challenges from a technical standpoint due to their makeup. The lumen of a chronically occluded artery becomes intensely fibrotic and calcified, in particular at the proximal and distal end of the occlusion (termed fibrotic caps). Percutaneous interventions for these lesions require highly skilled operators, and a variety of new guidewires and small profile balloon to cross these lesions have brought to the marketplace in the recent years. Despite these advances, success remains significantly lower than for non-occlusive lesions, at about 75% (for review see Stone et el, 2005). TechnologyInvestigators have developed a novel balloon based on modification of existing angioplasty balloon technology, that forces the guidewire to adopt a position close to the centerline of the vessel, and thus facilitating the penetration of the fibrotic cap in a central position, in order to increase the success of percutaneous coronary intervention (PCI)s for chronic total occlusions (CTOs).Application1. Treatment of chronic total occlusions of coronary arteries. Advantages1. Guidewire adopts a position closer to the centerline of the vessel, thus facilitating the penetration of the dense fibrotic cap.Stage of DevelopmentPrototypeProvisional patent application filed

*Principal Investigator

Name: Joon Lee

Department: Med-Medicine

Name: Anson Smith

Department: Med-Medicine

Name: Catalin Toma

Department: Med-Medicine

Country/Region

USA