A light-reflecting balloon catheter for atraumatic tissue defect repair

Abstract

A congenital or iatrogenic tissue defect often requires closure by open surgery or metallic components that can erode tissue. Biodegradable, hydrophobic light-activated adhesives represent an attractive alternative to sutures, but lack a specifically designed minimally invasive delivery tool, which limits their clinical translation. We developed a multifunctional, catheter-based technology with no implantable rigid components that functions by unfolding an adhesive-loaded elastic patch and deploying a double-balloon design to stabilize and apply pressure to the patch against the tissue defect site. The device uses a fiber-optic system and reflective metallic coating to uniformly disperse ultraviolet light for adhesive activation. Using this device, we demonstrate closure on the distal side of a defect in porcine abdominal wall, stomach, and heart tissue ex vivo. The catheter was further evaluated as a potential tool for tissue closure in vivo in rat heart and abdomen and as a perventricular tool for closure of a challenging cardiac septal defect in a large animal (porcine) model. Patches attached to the heart and abdominal wall with the device showed similar inflammatory response as sutures, with 100% small animal survival, indicating safety. In the large animal model, a ventricular septal defect in a beating heart was reduced to <1.6 mm. This new therapeutic platform has utility in a range of clinical scenarios that warrant minimally invasive and atraumatic repair of hard-to-reach defects.

Light-degradable hydrogels as dynamic triggers for gastrointestinal applications

“…The material properties, device shape, degradation timeline, and method of delivering light stimuli can all be individually tuned to suit different clinical needs. Previous studies of photodynamic therapy in the body using light-emitting thin films or optical fibers can, for example, be used in conjunction with our material to develop light-responsive implantable devices for a range of applications (58,59). Moreover, optical stimuli can be combined with other types of stimuli to enable materials capable of responding to a range of environmental signals, as required (19,60).…”

Integration of deployable fluid lenses and reflectors with endoluminal therapeutic ultrasound applicators: Preliminary investigations of enhanced penetration depth and focal gain

“…possible . Further, precisely shaped noncompliant balloons with a reflective multilumen compartment or coating have been demonstrated and integrated with ultrasonic and fiber optic sources, respectively . Greater technical difficulty may be associated with the integration and controlled distension of the convex lens.…”

“…38 Further, precisely shaped noncompliant balloons with a reflective multilumen compartment or coating have been demonstrated and integrated with ultrasonic and fiber optic sources, respectively. 15,39 Greater technical difficulty may be associated with the integration and controlled distension of the convex lens. Bonding the distensible membrane to the noncompliant balloon could potentially be achieved using thermoplastic welding techniques (e.g., laser, RF) or with flexible medical-grade adhesives to preserve compact collapse.…”

Programmable Medicine: Autonomous, Ingestible, Deployable Hydrogel Patch and Plug for Stomach Ulcer Therapy

“…Fibrin glue is one of the most common materials, although the adhesion it provides is relatively weak [21]. Recent developments have yielded bio-compatible sealants usable in both wet and dry conditions; chemical sealants such as glue-based adhesives [22], poly-based adhesives including hydrogels [23], [24], and mechanical sealants such as ulcerdressing patches including a bio-inspired one [25], [26].…”