Kevin LaDow, medical product manager at Junkosha, explains the technology behind solutions such as Multi-Filar and MCT, as well as reviews the next steps needed by end users as patient care continues to top the agenda for healthcare settings across the globe.
The journey towards intelligent catheters is an important one, both from the clinician’s and the patient’s perspective. Their development is necessary to accelerate the shift from costly, burdensome surgical treatments towards cost-effective and minimally invasive interventions. To treat a wider range of patients and types of disease, it is crucial to have smaller and more flexible, high signal capacity catheters at the surgery team’s disposal. This type of tool will provide surgeons with the high-quality imaging to precisely identify patient anatomy to help maximise the safety and efficacy of the procedure. Decreasing the size and increasing the flexibility of these catheters will help the physician more effectively navigate demanding patient anatomy, resulting in efficient and accurate devices or therapeutic delivery. Together, these advancements result in tangible, direct benefits for the patients, such as greater access to safer, less invasive procedures, with quicker recovery times.
Intelligent catheters, with new diagnostic and therapeutic capabilities, will enable the development of new, advanced therapies for diseases that are currently treated by complex surgical procedures. This will allow for more individuals to be treated and minimise risks, improving quality of life and reducing death rates for these patients. Intelligent catheters will allow a wider range of functions to be integrated into single, small devices in a cost-effective and industrially feasible manner. Since catheter-based procedures are typically done on an outpatient basis, they do not require an expensive OR suite or recovery in a hospital bed.
To this end, solutions such as Multi-Filar Cables and Multi-Channel Transmission Cables (MCT) represent a breakthrough in the design of medical device cables that take us closer to the next generation of these important devices.
The innovation behind the Multi-Filar active cables is significant. Multi-Filar cables can have a capacity of up to 60 lines and are designed to provide not only increased functionality but also more signals into formerly inaccessible areas of the body.
Using Junkosha’s PTFE lamination technology, single strand configurations are joined into a Multi-Filar assembly that can be used in electrophysiology catheters for applying pacing and recording protocols from inside the heart, ablation and balloon ablation catheters for atrial fibrillation as well as cardiac mapping.
The Multi-Filar technique also allows for easier assembly of the signal or power wires into the final medical device, making the overall manufacturing process simpler and more cost-effective.
The manufacturing process is complicated, which Junkosha has refined by being able to accommodate the specific requirements for the final product design. For example, each individual strand can be colour coded in the material, in accordance with specific industry standards or to make connection operations more simplified in downstream operations. The bond strength between the individual strands can be adjusted to maximise strength for challenging assembly conditions or optimised for difficult separation processes. Multi-Filar configurations allow for joining dissimilar single strand alloys together in one package. This flexibility in alloy selection is suited for applications like thermocouples, micro cables that need a high strength member for load bearing or assembly operations and electrochemical process cells.
Multi-Channel Transmission (MCT) cables are another step towards intelligent catheters. MCT represents a significant improvement on existing shielded twisted pair, coaxial and Flexible Printed Circuit technology and enables new data-rich signals to be utilised in therapies such as Intracardiac Echocardiogram, Ultrasound Endoscopy and Intervascular Ultrasound (IVUS).
Existing catheters use shielded twisted pair or coaxial constructs to support signals along the device. This established technology has driven advances in catheter design and facilitated the delivery of many essential interventional, intervascular diagnostics and therapies. However, the progress towards miniaturisation and flexibility has been hampered by the standard coaxial approach which comprises a core conductor, insulation, and a shield wire. Physics and electromagnetics have prevented the development of smaller cables and has inhibited catheter flexibility.
In contrast, the new MCT cable design includes four times the amount of signal lines per individual cable, while preserving signal to noise performance. This is thanks to Junkosha’s shielding/grounding design. Whereas the traditional catheter requires two coaxial cables to run in parallel carrying two individual signal streams, MCT enables multiples of four signals to be brought together in one cable.
Early prototypes have achieved a 32% reduction in the size of the cable, a critical factor in the attainment of future procedures within narrower vessels. The MCT approach also provides a greater degree of flexibility compared to the existing approaches which promises major advances in the scope of medical procedures, especially within endoscopy. Overall, this innovation addresses the mutually exclusive needs of small size and signal integrity simultaneously. This in turn unlocks opportunities for catheter manufacturers to deliver valuable, previously unrealised options, to clinicians.
As the requirement for smaller and smaller devices increases for a wider variety of therapies, so the need for innovations like the MCT solution become paramount to enable them.
The pace of change in the medical device sector is increasing continuously. An example of this is the development of mapping catheters, which are used during cardiac and electrophysiological therapies. Mapping catheters help physicians to discover and evaluate the electroanatomical layout of the heart and surrounding area. Previously believed to be impossible, catheter-based solutions are now available to accurately pinpoint problems within blood vessels and the heart. Interventional procedures utilising intelligent catheters rather than high-risk surgery will allow medical teams all over the world to decrease the risk to all patients, decrease recovery times, and to develop new therapies to heal diseases that until now have been impossible to treat.
As the requirement for complex catheter-based procedures increases, the need for innovations such as the Multi-Filar Cables and the Multichannel Transmission Cables become paramount to enable them. Solutions such as these are continually pushing the boundaries of what is possible with minimally invasive devices and intelligent catheters, unlocking opportunities for OEMs to deliver improved patient outcomes, quicker recovery times, and lower costs of care. These solutions will be key to expanding the capabilities of medical teams around the world, helping reach maximum levels of medical quality and patient care, even in areas where, traditionally, medical resources have been scarce.
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