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New Endovascular Method for Transvascular Exit of Arteries and Veins: Developed in Simulator, in Rat and in Rabbit with Full Clinical Integration

BACKGROUND: Endovascular technique has benefits vis-a-vis surgical access to organs with less accessible anatomical locations. To minimize surgical risk we propose a novel endovascular technique, to create parenchymal access through endovascular methods. METHODOLOGY/PRINCIPAL FINDINGS: We have devel...

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Autores principales: Lundberg, Johan, Jonsson, Stefan, Holmin, Staffan
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862716/
https://www.ncbi.nlm.nih.gov/pubmed/20454668
http://dx.doi.org/10.1371/journal.pone.0010449
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author Lundberg, Johan
Jonsson, Stefan
Holmin, Staffan
author_facet Lundberg, Johan
Jonsson, Stefan
Holmin, Staffan
author_sort Lundberg, Johan
collection PubMed
description BACKGROUND: Endovascular technique has benefits vis-a-vis surgical access to organs with less accessible anatomical locations. To minimize surgical risk we propose a novel endovascular technique, to create parenchymal access through endovascular methods. METHODOLOGY/PRINCIPAL FINDINGS: We have developed, manufactured and tested an endovascular catheter with a depth limiting collar and a penetrating tip that is used to perforate vessels, thereby creating a working channel to the extra-vascular space. Computer simulations and subsequent interventions have been performed ex vivo and in vivo in both small and large animals by testing different prototypes. All tests were designed for testing extravascular hemostasis and absence of thrombo-embolic complications when exiting the vessels from the inside to the extra vascular space. We have deposited prototypes after intervention in vascular walls over a period of 14 days in rat with no impairment on blood flow and no signs of thrombo-embolic complications upon re-exploration (n = 7). We have also incorporated the catheter system with clinically available systems both in an ex vivo simulator setting and in a full scale clinical angiographical setting in rabbit were no bleeding (0%) in any of the interventions performed (n = 40). To prevent hemorrhage during termination of the procedure, a hollow electrolysis detachment-zone leaves the distal tip in the vessel-wall after the intervention. This has also been tested with absolute hemostasis in large animals (n = 6). CONCLUSIONS/SIGNIFICANCE: We have developed and tested a new system for transvascular tissue access in simulations, ex vivo and in vivo in small and large animals, integrating it with standard clinical catheters and angiographical environment, with absolute hemostasis and without thromboembolic complications. In a clinical setting for stem cell transplantation, local substance administration or tissue sampling, the benefit should be greatest in organs that are difficult or high-risk to access with other techniques, such as the pancreas, the central nervous system (CNS) and the heart.
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spelling pubmed-28627162010-05-07 New Endovascular Method for Transvascular Exit of Arteries and Veins: Developed in Simulator, in Rat and in Rabbit with Full Clinical Integration Lundberg, Johan Jonsson, Stefan Holmin, Staffan PLoS One Research Article BACKGROUND: Endovascular technique has benefits vis-a-vis surgical access to organs with less accessible anatomical locations. To minimize surgical risk we propose a novel endovascular technique, to create parenchymal access through endovascular methods. METHODOLOGY/PRINCIPAL FINDINGS: We have developed, manufactured and tested an endovascular catheter with a depth limiting collar and a penetrating tip that is used to perforate vessels, thereby creating a working channel to the extra-vascular space. Computer simulations and subsequent interventions have been performed ex vivo and in vivo in both small and large animals by testing different prototypes. All tests were designed for testing extravascular hemostasis and absence of thrombo-embolic complications when exiting the vessels from the inside to the extra vascular space. We have deposited prototypes after intervention in vascular walls over a period of 14 days in rat with no impairment on blood flow and no signs of thrombo-embolic complications upon re-exploration (n = 7). We have also incorporated the catheter system with clinically available systems both in an ex vivo simulator setting and in a full scale clinical angiographical setting in rabbit were no bleeding (0%) in any of the interventions performed (n = 40). To prevent hemorrhage during termination of the procedure, a hollow electrolysis detachment-zone leaves the distal tip in the vessel-wall after the intervention. This has also been tested with absolute hemostasis in large animals (n = 6). CONCLUSIONS/SIGNIFICANCE: We have developed and tested a new system for transvascular tissue access in simulations, ex vivo and in vivo in small and large animals, integrating it with standard clinical catheters and angiographical environment, with absolute hemostasis and without thromboembolic complications. In a clinical setting for stem cell transplantation, local substance administration or tissue sampling, the benefit should be greatest in organs that are difficult or high-risk to access with other techniques, such as the pancreas, the central nervous system (CNS) and the heart. Public Library of Science 2010-05-03 /pmc/articles/PMC2862716/ /pubmed/20454668 http://dx.doi.org/10.1371/journal.pone.0010449 Text en Lundberg et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Lundberg, Johan
Jonsson, Stefan
Holmin, Staffan
New Endovascular Method for Transvascular Exit of Arteries and Veins: Developed in Simulator, in Rat and in Rabbit with Full Clinical Integration
title New Endovascular Method for Transvascular Exit of Arteries and Veins: Developed in Simulator, in Rat and in Rabbit with Full Clinical Integration
title_full New Endovascular Method for Transvascular Exit of Arteries and Veins: Developed in Simulator, in Rat and in Rabbit with Full Clinical Integration
title_fullStr New Endovascular Method for Transvascular Exit of Arteries and Veins: Developed in Simulator, in Rat and in Rabbit with Full Clinical Integration
title_full_unstemmed New Endovascular Method for Transvascular Exit of Arteries and Veins: Developed in Simulator, in Rat and in Rabbit with Full Clinical Integration
title_short New Endovascular Method for Transvascular Exit of Arteries and Veins: Developed in Simulator, in Rat and in Rabbit with Full Clinical Integration
title_sort new endovascular method for transvascular exit of arteries and veins: developed in simulator, in rat and in rabbit with full clinical integration
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862716/
https://www.ncbi.nlm.nih.gov/pubmed/20454668
http://dx.doi.org/10.1371/journal.pone.0010449
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