I-Corps: Device for subdural hematoma visualization and access during evacuation

I-Corps：在疏散过程中用于硬膜下血肿可视化和访问的设备

• 批准号: 2234713
• 负责人: Benjamin Rapoport
• 金额: $ 5万
• 依托单位: Icahn School of Medicine at Mount Sinai
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2234713&HistoricalAwards=false
• 关键词: Corps; Device; subdural; hematoma; visualization

The broader impact/commercial potential of this I-Corps project is the development of a subdural hematoma removal (evacuation) device. Subdural hematoma is the most common surgically treated neurological disease, occurring due to traumatic brain injury and chronically in older populations. Over 100,000 hematoma cases undergo neurosurgical intervention every year. This incidence rate is expected to increase with an aging population with frequent anticoagulant usage. Interventions can be categorized as passive drainage evacuation and active drainage evacuation. Active drainage requires the patient to be in the operating room and results in higher evacuation rates. Passive drainage procedures are done at the bedside, which is beneficial for the aging population due to the less invasive nature of the procedure, but it is not nearly as effective as active drainage procedures. Intended to be used at the bedside, the proposed technology may allow for a minimally invasive subdural hematoma evacuation procedure that minimizes recurrence rates and postoperative complications. Additionally, if employed in the intensive care unit (ICU), the procudure may result in lower hospital and patient costs compared with procedures done in the operating room. This I-Corps project is based on the development of a minimally invasive subdural hematoma evacuation kit that provides maximal subdural hematoma evacuation by taking advantage of neuroendoscopy and active suction. The kit includes a ”periscope” device that is specially designed to maximize subdural hematoma visualization and access during evacuation. This technology may allow the surgeon to visualize and remove the hematoma in a non-invasive manner, resulting in an improved procedure. Current systems are either too invasive or not effective at evacuating the subdural hematoma. Invasive procedures can be dangerous, especially for patients over 65 years old, due to complications after surgery. Alternatively, the minimally invasive procedures provide less visualization of the hematoma and often no active suction. These operative conditions result in high recurrence rates, with the patient returning a few months later with a resurfaced hematoma. The proposed technology is intended to be used in the intensive care unit and, if successful, may have the ability to decrease recurrences, postoperative complications, and total hospital and patient costs.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

该I-Corps项目的更广泛影响/商业潜力是开发硬膜下血肿清除（清除）器械。硬膜下血肿是最常见的手术治疗的神经系统疾病，由于创伤性脑损伤而发生，并且在老年人群中是慢性的。每年有超过100，000例血肿病例接受神经外科干预。随着频繁使用抗凝剂的老龄化人群，该发生率预计会增加。干预措施可分为被动引流和主动引流。主动引流需要患者在手术室中，并导致更高的后送率。被动引流手术是在床边进行的，由于手术的侵入性较小，这对老龄化人群是有益的，但它远不如主动引流手术有效。拟在床边使用，所提出的技术可以允许微创硬膜下血肿清除术，最大限度地减少复发率和术后并发症。此外，如果在重症监护室（ICU）中使用，与手术室中进行的手术相比，该手术可能会降低医院和患者的成本。该I-Corps项目基于微创硬膜下血肿清除工具包的开发，该工具包通过利用神经内镜和主动抽吸提供最大程度的硬膜下血肿清除。 该套件包括一个“潜望镜”装置，专门设计用于最大限度地提高硬膜下血肿的可视化和清除过程中的访问。该技术可以使外科医生以非侵入性方式观察和清除血肿，从而改进手术。 目前的系统要么太侵入性，要么不能有效地清除硬膜下血肿。侵入性手术可能是危险的，特别是对于65岁以上的患者，由于手术后的并发症。或者，微创手术提供较少的血肿可视化，通常没有主动抽吸。这些手术条件导致高复发率，患者在几个月后返回时出现表面血肿。这项技术被用于重症监护室，如果成功，可能有能力减少复发，术后并发症，以及总的医院和病人costs.This奖项反映了NSF的法定使命，并已被认为是值得通过使用基金会的智力价值和更广泛的影响审查标准进行评估的支持。

项目成果

Endoscope-Assisted Evacuation of Subdural Hematoma and Middle Meningeal Artery Embolization in a Single Session in the Angiography Suite: 2-Dimensional Operative Video

在血管造影套件中单次进行内窥镜辅助硬膜下血肿清除和脑膜中动脉栓塞术：二维手术视频

• DOI: 10.1227/ons.0000000000000919
• 发表时间: 2023
• 期刊: Operative Neurosurgery
• 影响因子: 2.3
• 作者: Lara-Reyna, Jacques;Morgan, Isabella C.;Odland, Ian C.;Carrasquilla, Alejandro;Matsoukas, Stavros;Mocco, J;Bederson, Joshua B.;Kellner, Christopher P.;Rapoport, Benjamin I.
• 通讯作者: Rapoport, Benjamin I.