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Sensor-bedazzled balloon catheter speeds up heart surgery

By Janet Fang | March 7, 2011, 4:41 PM PST

A little while ago, cardiologists improved open-heart surgery by using super thin, flexible balloon catheters – or tubes inserted into the body to eliminate blockage in blood vessels and to introduce artificial tubes.

But the procedure remained painfully long and required switching between various catheters that do different things. “Those balloon catheters do not have any active surgical power,” says John Rogers of the University of Illinois at Urbana-Champaign. “They are just dumb mechanical instruments.”

Now, Rogers and colleagues have created multifunctional balloon catheters with flexible electronic sensors (pictured) that can deliver high-res, real-time information to surgeons, shortening surgery time. And it can also remove the damaged tissue. Diagnostic and treatment capabilities in one!

These less invasive cardiac catheters eliminate damaged tissue using heat, temperature and pressure sensors, an LED, and an electrocardiogram (EKG) sensor. They provide info about the depth of lesions, blood flow, electrical activity, and temperature at the exact spot – and deliver cardiac therapy to the patient.

Nature News explains:

The multifunctional balloon catheter is ideal for quickly diagnosing and treating the cause of irregular heartbeats, says Rogers. Currently, heart surgeons map tissue using pointed catheters with electrodes, which they move around slowly and carefully. When they find the abnormal tissue that can cause irregular heartbeats, they must insert a separate pointed catheter to remove it. “Most deaths during these procedures arise because of the time this takes,” says Rogers.

It’s difficult to create surgical tools that combine brittle, silicon computer chips and sensors in a material that’s compatible with the soft surfaces of internal organs.

So, for these particular rat heart surgeries, the researchers outfitted balloon catheters with stretchy, connected networks of electrodes and sensors (pictured). The trick was to make the silicon components a thousand times as thin as usual. These were connected with serpentine-shaped wires that buckle and change shape as the balloon inflates, rather than fracturing [Nature News].

“You can make an integrated device that can stretch by up to 300%, from flat to spherical, completely reversibly,” says Rogers. The stretchiness is important because all the necessary medical devices are on a section of the catheter that’s thinner than the rest (since it’s sunken in). There, the sensitive devices are protected during the catheter’s trip through the body to the heart. Once the catheter reaches its destination, the tube is inflated, and the thinner section expands, exposing the electronics to the heart.

“We put everything on the soft surface of a rubber balloon and blow it up without any of the devices failing,” Rogers says. After the catheter is in place, the individual devices can perform their specific tasks when needed:

pressure sensor determines the pressure on the heart
EKG sensor monitors the heart’s condition
temperature sensor controls the temp, to not damage good tissue
LED sheds light for imaging and also provides the energy for ‘ablation therapy,’ which eliminates bad tissue by creating lesions in the heart, controlling problems like arrhythmia.

This catheter could also be used in the bladder to monitor stretch and flow or in the lungs to monitor the risk of an asthma attack, according to study coauthor Brian Litt of the University of Pennsylvania. The researchers have started to create real-time maps of electrical activity in the brain during epileptic seizures.

So far, it’s only been used in anesthetized animals, but human trials with a simplified version could begin as early as this year.

The study was published in Nature Materials on Sunday.

Top image by Kevin Dowling, bottom image by Dae-Hyeong Kim

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About Janet Fang

Janet Fang is a contributing editor for SmartPlanet.

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RE: Sensor-bedazzled balloon catheter speeds up heart surgery

John Rogers is doing some really great stuff with flexible electronics - this heart monitoring and mapping epileptic seizures in real time is incredible.

Posted by Richard Van Noorden

8th Mar 2011

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Combination of Liberation Therapy and Stem Cell Implantation for

Chronic cerebrospinal venous insufficiency (CCSVI), or the pathological restriction of venous vessel discharge from the CNS has been proposed by Zamboni, et al, as having a correlative relationship to Multiple Sclerosis. From a clinical perspective, it has been demonstrated that the narrowed jugular veins in an MS patient, once widened, do affect the presenting symptoms of MS and the overall health of the patient. It has also been noted that these same veins once treated, restenose after a time in the majority of cases. Why the veins restenose is speculative. One insight, developed through practical observation, suggests that there are gaps in the therapy protocol as it is currently practiced. In general, CCSVI therapy has focused on directly treating the venous system and the stenosed veins. Several other factors that would naturally affect vein recovery have received much less consideration. As to treatment for CCSVI, it should be noted that no meaningful aftercare protocol based on evidence has been considered by the main proponents of the liberation therapy (neck venoplasty). In fact, in all of the clinics or hospitals examined for this study, patients werent required to stay in the clinical setting any longer than a few hours post-procedure in most cases. Even though it has been observed to be therapeutically useful by some of the main early practitioners of the liberation therapy, follow-up, supportive care for recovering patients post-operatively has not seriously been considered to be part of the treatment protocol. To date, follow-up care has primarily centered on when vein re-imaging should be done post-venoplasty. The fact is, by that time, most patients have restenosed (or partially restenosed) and the follow-up Doppler testing is simply detecting restenosis and retrograde flow in veins that are very much deteriorated due to scarring left by the initial procedure. This article discusses a variable approach as to a combination of safe and effective interventional therapies that have been observed to result in enduring venous drainage of the CNS to offset the destructive effects of inflammation and neurodegeneration, and to regenerate disease damaged tissue.
As stated, it has been observed that a number of presenting symptoms of MS almost completely vanish as soon as the jugulars are widened and the flows equalize in most MS patients. Where a small number of MS patients have received no immediate benefit from the liberation procedure, flows in subject samples have been shown not to have equalized post-procedure in these patients and therefore even a very small retrograde blood flow back to the CNS can offset the therapeutic benefits. Furthermore once the obstructed veins are further examined for hemodynamic obstruction and widened at the point of occlusion in those patients to allow full drainage, the presenting symptoms of MS retreat. This noted observation along with the large number of MS patients who have CCSVI establish a clear association of vein disease with MS, although it is clearly not the disease trigger.For more information please visit http://www.ccsviclinic.ca/?p=978

Posted by Leo Voisey

29th Jul

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RE: Sensor-bedazzled balloon catheter speeds up heart surgery

John Rogers is doing some really great stuff with flexible electronics - this heart monitoring and mapping epileptic seizures in real time is incredible.

Posted by Richard Van Noorden

8th Mar 2011

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What are Stem Cells?

Stem cells are ???non-specialized??? cells that have the potential to form into other types of specific cells, such as blood, muscles or nerves. They are unlike "differentiated" cells which have already become whatever organ or structure they are in the body. Stem cells are present throughout our body, but more abundant in a fetus.
Medical researchers and scientists believe that stem cell therapy will, in the near future, advance medicine dramatically and change the course of disease treatment. This is because stem cells have the ability to grow into any kind of cell and, if transplanted into the body, will relocate to the damaged tissue, replacing it. For example, neural cells in the spinal cord, brain, optic nerves, or other parts of the central nervous system that have been injured can be replaced by injected stem cells. Various stem cell therapies are already practiced, a popular one being bone marrow transplants that are used to treat leukemia. In theory and in fact, lifeless cells anywhere in the body, no matter what the cause of the disease or injury, can be replaced with vigorous new cells because of the remarkable plasticity of stem cells. Biomed companies predict that with all of the research activity in stem cell therapy currently being directed toward the technology, a wider range of disease types including cancer, diabetes, spinal cord injury, and even multiple sclerosis will be effectively treated in the future. Recently announced trials are now underway to study both safety and efficacy of autologous stem cell transplantation in MS patients because of promising early results from previous trials.
History
Research into stem cells grew out of the findings of two Canadian researchers, Dr???s James Till and Ernest McCulloch at the University of Toronto in 1961. They were the first to publish their experimental results into the existence of stem cells in a scientific journal. Till and McCulloch documented the way in which embryonic stem cells differentiate themselves to become mature cell tissue. Their discovery opened the door for others to develop the first medical use of stem cells in bone marrow transplantation for leukemia. Over the next 50 years their early work has led to our current state of medical practice where modern science believes that new treatments for chronic diseases including MS, diabetes, spinal cord injuries and many more disease conditions are just around the corner.
There are a number of sources of stem cells, namely, adult cells generally extracted from bone marrow, cord cells, extracted during pregnancy and cryogenically stored, and embryonic cells, extracted from an embryo before the cells start to differentiate. As to source and method of acquiring stem cells, harvesting autologous adult cells entails the least risk and controversy.
Autologous stem cells are obtained from the patient???s own body; and since they are the patient???s own, autologous cells are better than both cord and embryonic sources as they perfectly match the patient???s own DNA, meaning that they will never be rejected by the patient???s immune system. Autologous transplantation is now happening therapeutically at several major sites world-wide and more studies on both safety and efficacy are finally being announced. With so many unrealized expectations of stem cell therapy, results to date have been both significant and hopeful, if taking longer than anticipated.
What???s been the Holdup?
Up until recently, there have been intense ethical debates about stem cells and even the studies that researchers have been allowed to do. This is because research methodology was primarily concerned with embryonic stem cells, which until recently required an aborted fetus as a source of stem cells. The topic became very much a moral dilemma and research was held up for many years in the US and Canada while political debates turned into restrictive legislation. Other countries were not as inflexible and many important research studies have been taking place elsewhere. Thankfully embryonic stem cells no longer have to be used as much more advanced and preferred methods have superseded the older technologies. While the length of time that promising research has been on hold has led many to wonder if stem cell therapy will ever be a reality for many disease types, the disputes have led to a number of important improvements in the medical technology that in the end, have satisfied both sides of the ethical issue.
CCSVI Clinic
CCSVI Clinic has been on the leading edge of MS treatment for the past several years. We are the only group facilitating the treatment of MS patients requiring a 10-day patient aftercare protocol following neck venous angioplasty that includes daily ultrasonography and other significant therapeutic features for the period including follow-up surgeries if indicated. There is a strict safety protocol, the results of which are the subject of an approved IRB study. The goal is to derive best practice standards from the data. With the addition of ASC transplantation, our research group has now preparing application for member status in International Cellular Medicine Society (ICMS), the globally-active non-profit organization dedicated to the improvement of cell-based medical therapies through education of physicians and researchers, patient safety, and creating universal standards. For more information please visit http://www.neurosurgeonindia.org/

Posted by Leo Voisey

30th Mar 2012

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MS was my Previous Diagnosis

David Summers, a 37 year old MS patient from Murfreesboro, Tennessee was a score of 8.0 on the Expanded Disability Status Scale (EDSS) when he had the Combination Liberation Therapy and Stem Cell Transplantation at CCSVI Clinic in March of 2012. Having been diagnosed in 1996 he had been in a wheelchair for the past decade without any sensation below the waist or use of his legs.
???It was late 2011 and I didn???t have much future to look forward to??? says David. ???My MS was getting more progressive and ravaging my body. I was diagnosed as an 8.0 on the EDSS scale; 1 being mild symptoms, 10 being death. There were many new lesions on my optic nerves, in my brain and on my spinal cord. My neurologist just told me: ???be prepared to deteriorate???. I knew that he was telling me I didn???t have much time left, or at least not much with any quality.??? David had previously sought out the liberation therapy in 2010 and had it done in a clinic in Duluth Georgia. ???The Interventional Radiologist who did it told me that 50% of all MS patients who have the jugular vein-clearing therapy eventually restenose. I didn???t believe that would happen to me if I could get it done. But I have had MS for 16 years and apparently my veins were pretty twisted up???. Within 90 days, David???s veins had narrowed again, and worse, they were now blocked in even more places than before his procedure.
???I was so happy after my original procedure in 2010. I immediately lost all of the typical symptoms of MS. The cog fog disappeared, my speech came back, the vision in my right eye improved, I was able to regulate my body temperature again, and some of the sensation in my hands came back. But as much as I wanted to believe I felt something, there was nothing below the waist. I kind of knew that I wouldn???t get anything back in my legs. There was just way too much nerve damage now???. But any improvements felt by David lasted for just a few months.
After his relapse, David and his family were frustrated but undaunted. They had seen what opening the jugular veins could do to improve him. Because the veins had closed so quickly after his liberation procedure, they considered another clinic that advocated stent implants to keep the veins open, but upon doing their due diligence, they decided it was just too risky. They kept on searching the many CCSVI information sites that were cropping up on the Internet for something that offered more hope. Finding a suitable treatment, especially where there was no known cure for the disease was also a race against time. David was still suffering new attacks and was definitely deteriorating. Then David???s mother Janice began reading some patient blogs about a Clinic that was offering both the liberation therapy and adult autologous stem cell injections in a series of procedures during a hospital stay. ???These patients were reporting a ???full recovery??? of their neurodegenerative deficits??? says Janice, ???I hadn???t seen anything like that anywhere else???. She contacted CCSVI Clinic in late 2011 and after a succession of calls with the researchers and surgeons they decided in favor of the combination therapies.
???I went to CCSVI Clinic in India without knowing what to expect??? says David, ???but I basically had one shot left and this was it. I was becoming pretty disabled, and I couldn???t think very clearly???. David was triaged with a clinic intake of other MS patients and had the liberation therapy on March 27, 2012. They also drew bone marrow from his hip bone in the same procedure. When he woke up from the procedure, he again felt the immediate effect of the widening of the veins. ???In case anyone doesn???t believe that the liberation therapy works, I can tell them that this is much more than placebo effect.??? The MS symptoms described earlier again disappeared. Four days later he had the first of the stem cell injections from the cultured cells taken from his hip bone during the liberation therapy. The first transplant was injected into the area just below his spine. Over the next 4 days he would receive about 100 million stem cells cultured in specific growth factors for differentiated effect.
He was not quite prepared for what happened next. A few hours after the first transplant, he was taken back into his hospital room and was transferred to the hospital bed. ???I???m not completely helpless when it comes to moving from a chair or a bed???, says David, ???One of the things I can do for myself is to use my arms to throw my leg into a position to be able to shift the rest of my body weight over to where I???m going. But this time to my amazement, I didn???t have to pick up the dead weight of my leg and throw it. It moved on its own, exactly where my brain told it to go???. Shortly after his first stem cell transplant procedure, some motor function in his lower body had returned. ???This was the first time in 10 years I had any sensation or motor function below my waste so it was quite a shock.???
In the next month, most every motor nerve and body function has either returned or is on its way to recovery. ???It???s been over a decade since I???ve had any power over my elimination functions. Now it???s all come back. I have total bladder control???. He???s also working out every day, following the physiotherapy routine given him by the clinic. ???For years, I haven???t been able to work out without getting sick for a couple of days afterward. Now I have muscles popping out all over the place where I haven???t seen them since my MS became progressive???and I can work out as hard or as much as I want. With my ability to do the hard work my balance is improving each day and I???m able to take steps unassisted. I???m definitely going to be coming all the way back.???
Dr. Av Gupte, the neurosurgeon who has now done over 2000 adult autologous stem cell transplants for various neurologic disease conditions says that the stem cells in David???s body will continue to work their healing process for the next year. ???With the incredible progress I???ve seen so far, I won???t need a year???, says David. ???It???s only been a little over two months and I have most everything back. I can???t wait to get up each day to check out my improvements. My right hand is completely back to normal without any numbness and the left is on its way. I have good strength in my legs now and I???m working on the balance???.
Other MS patients treated with the combination therapy over the past 18 months have seen similar improvements but none have been as disabled as David. ???If I can come back from where I was, most everyone with MS could too. For me, CCSVI Clinic has been my miracle and I can???t say enough about the doctors, researchers and staff who are helping me to recover. For me, MS was my previous diagnosis???.For more information please visit http://www.ccsviclinic.ca/?p=904

Posted by Leo Voisey

4th Jun

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Combination of Liberation Therapy and Stem Cell Implantation for

Posted by Leo Voisey

29th Jul

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