TY - JOUR
T1 - A light-reflecting balloon catheter for atraumatic tissue defect repair
AU - Roche, Ellen T.
AU - Fabozzo, Assunta
AU - Lee, Yuhan
AU - Polygerinos, Panagiotis
AU - Friehs, Ingeborg
AU - Schuster, Lucia
AU - Whyte, William
AU - Berazaluce, Alejandra Maria Casar
AU - Bueno, Alejandra
AU - Lang, Nora
AU - Pereira, Maria J.N.
AU - Feins, Eric
AU - Wasserman, Steven
AU - O'Cearbhaill, Eoin D.
AU - Vasilyev, Nikolay V.
AU - Mooney, David J.
AU - Karp, Jeffrey M.
AU - Del Nido, Pedro J.
AU - Walsh, Conor J.
PY - 2015/9/23
Y1 - 2015/9/23
N2 - 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.
AB - 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.
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U2 - 10.1126/scitranslmed.aaa2406
DO - 10.1126/scitranslmed.aaa2406
M3 - Article
C2 - 26400910
AN - SCOPUS:84942549181
SN - 1946-6234
VL - 7
JO - Science Translational Medicine
JF - Science Translational Medicine
IS - 306
ER -