137. neurotendo: nintendo for neurointerventionists

Department: Mechanical & Aerospace Engineering
Faculty Advisor(s): James R. Friend
Award(s): Honorable Mention

Primary Student
Name: Gopesh Chaitanyaku Tilvawala
Email: gtilvawa@ucsd.edu
Phone: 858-226-6795
Grad Year: 2020

Abstract
One-sixth to one-fourth of endovascular surgical neurointerventions fail in attempting to treat neurovascular aneurysms, a disease that imposes an enormous socio-economic burden. The failure rate is principally due to the difficulty in orienting the microcatheter to access the aneurysm after navigation via the tortuous neurovasculature. The objective of this project is to overcome this problem through delivery of complete and direct handheld control of the microcatheter tip?s orientation to the neurointerventionist. Our approach combines the use of novel 3D microprinting and cast molding techniques with soft robotics and direct hydraulic microactuation via a simple hand controller to provide steerable microcatheter tip?s at the small (∼50 μm) scales necessary for endovascular neurointervention, far smaller than the wire-pulley steerable catheters for cardiac intervention, and genuinely hand-steerable unlike the passively floppy soft microcatheters claimed to be ?steerable? on the market today. The 3D microprinting and casting method is compatible with the 750 μm diameter microcatheter and 50 μm deformable hydraulic passages within that are necessary for steering, including a 500 μm lumen within the microcatheter tip to carry coils into the aneurysm. Irrelevant in traditional stent balloons, but crucial in this application, radial expansion of the tip is precluded by tailoring the stress-strain response of the device?s hyperelastic polymers. The final aim is to incorporate the steerable microcatheter tip and novel navigation techniques devised into a 1.6 m long microcatheter system for animal trials to pave the way towards eventual clinical use. The outcome of this effort is a steerable microcatheter system and the associated design and fabrication data. With the steerable microcatheter system, endovascular neurointerventionists will be able to target any part of the vasculature more quickly, safely, and with far greater flexibility. We focus on coil delivery improvement, enabling treatment in a far greater number of cases and using fewer microguidewires and catheters per surgery, reducing healthcare costs and improving intervention outcomes. This technology would likewise improve other methods of endovascular treatment, whether by flow diversion, microstent support, or otherwise, providing tactile navigation tools impossible today. Microcatheter steering to treat aneurysms initiates a logical step in this long-term effort, solving the key problems plaguing coil delivery; the experience and data gained in design and fabrication of this device facilitates the broader pursuit of surgical maneuverability at small scales necessary for minimally invasive treatment of many diseases and injuries to result in improved patient outcomes and reduced healthcare costs for all.

Industry Application Area(s)
Life Sciences/Medical Devices & Instruments

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