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Meditech Challenge – Vascular Surgery

New Technologies for Vascular Surgery

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Challenges
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Selected Solver
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Mentors
15
Weeks

The Challenge will take place from February to May 2024

Find out how to apply by in this webpage

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What is the Meditech Challenge – Vascular Surgery?

It’s an initiative that allows PhD and MSc students from the University of Trento to collaborate with young vascular surgeons to tackle challenges in the field of vascular surgery. Large companies in the medical tech field are involved as sponsors and mentors. A unique opportunity to explore future scientific and engineering careers in the medical tech sector.

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What is Vascular Surgery?

Vascular surgery refers to open surgery and minimally-invasive procedures that treat a range of blood vessel problems. These include aortic aneurysms, peripheral artery disease, carotid artery disease and chronic venous insufficiency. To treat these diseases involves the implant of highly engineered prostheses and stents, the use of operating devices, and data acquisition machinery (X-ray and CAT-scan machinery).

What challenges and topics will you work on?

1. SMART PROSTHESES (STENTS)

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CHALLENGE! New designs for metal stents and prosthesis that are more adherent to patient’s anatomy (aortic curve) and can detect failures (movements).

  • Mechanical engineering
  • Advanced materials
  • Computational fluidodynamics
  • Sensorization and IoT
  • Additive manufacturing
  • Biomaterials
  • Physics and mathematics
  • Predictive models

PROBLEM: Vascular surgery often operates aneurisms (abnormal and permanent dilation of the arterial wall) by implanting bypass prostheses based on a PTE / PTFE fabric tube and a shape-memory metallic stent that keeps the tube open by means of a radial force. Stents come in standard sizes: however, they need to fit to the anatomy of different patients, which may vary considerably across patients, and within the same patient across time, causing adherence problems over time. Also, the pressure applied by the blood stream may cause malfunctions (movements) of the prosthesis, which may require additional interventions.

IDEAS: Is it possible to conceive more personalized stents, with more adaptable sizes and radial force, and / or that could be tailored to patients’ anatomy right before the intervention, possibly involving additive manufacturing (3D printing)? Can the stent design be improved in a way that the blood stream is less affected (lower turbulence), e.g., by utilizing new materials that allows for a thinner thickness of the prosthesis (PTFE-carbon sandwich)? Is it possible to sensorize prosthesis in a way that they can detect changes in the blood stream pressure and therefore failures? What source of energy should such sensors harvest?

2. SOLUTIONS TO ENDOLEAK TYPE 2

CHALLENGE! New methods and materials to fill the aneurismal sac once the prosthesis is implanted (this avoids the sac to get filled with blood that become prone to thrombosis).

  • Mechanical engineering
  • Advanced materials
  • Computational fluidodynamics
  • Sensorization and IoT
  • Additive manufacturing
  • Biomaterials
  • Physics and mathematics
  • Predictive models

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PROBLEM: A type II endoleak occurs when, after the implant of a prostheses, small peripheral arteries keep on supply blood to the aneurysmal sac, which becomes unstable and threaten the health of an operated patient. This problem has been addressed by preventive actions during the implant of the prosthesis, such as embolization of the sac with thrombogenic material (but this is not time-efficient) or by filling the sac with a polymer (but this proven to fail due to the mass of the material and mismatch of mechanical properties with the sac). Prostheses with peptide filaments functionalized with amino acids (with a great ability to coagulate blood) have been explored, but not industrialized.

IDEAS: Is it possible to fill the aneurysmal sac with biocompatible materials that allow to seal the arteries that supplying blood? Would hydrogel be suitable, or would it prove to be too heavy? Would aerogel be suitable, considered that its niches would be inhabited by clotted blood? Would compressed sponges be an option, and what could the activating trigger be? Would bidimensional materials attached to the prosthesis be suitable?

3. ROBOTS FOR VASCULAR SURGERY

Two Surgeons Observing High Precision Programmable Automated Robot Arms Operating Patient In Futuristic Hospital. Robotic Limbs Performing Advanced Nanosurgery, Doctors Looking At Vitals On Monitor

Two Surgeons Observing High Precision Programmable Automated Robot Arms Operating Patient In Futuristic Hospital. Robotic Limbs Performing Advanced Nanosurgery, Doctors Looking At Vitals On Monitor

Two Surgeons Observing High Precision Programmable Automated Robot Arms Operating Patient In Futuristic Hospital. Robotic Limbs Performing Advanced Nanosurgery, Doctors Looking At Vitals On Monitor

CHALLENGE! New concepts for robots capable of implanting a prosthesis that could be employed for remote operations.

  • Mechanical engineering
  • Robotics
  • Computational fluidodynamics
  • Sensorization and IoT
  • Industrial Engineering
  • Augmented reality
  • Physics and mathematics
  • Artificial intelligence

PROBLEM: Implanting a prosthesis involves a high degree of dexterity and expert practical knowledge which involves operating a rotating coaxial systems made of objects that slide and rotate on each other: catheters, soft guides, rigid guides, tracks, and the stent/prosthesis. All needs to be inserted in the artery from one limb (e.g., the femoral artery), and guided up the body until they reach the right position (abdomen or aorta where the aneurysm is). To make things more complicated, arteries can make 90° bends, loops, and there are bifurcations. The haptic feedback provided by the guides to the surgeon is key. Is it possible to conceive a robot and command / feedback system suitable to allow the surgeon to perform a prosthesis installation operation remotely, maybe on standard / simple interventions? This would also solve the RX exposure problem (surgeons need to use live RX to see inside the patient and locate the prosthesis being implanted, and the various devices used for its installation).

IDEAS: There are early robotic solutions in the market (e.g., Magellan, Sentante, CorPath, Robocath, and another Chinese project based on biomimetic manipulation. Other products are little used due to poor ergonomics (joystick interface). A key challenge is ensuring haptic feedback to the interface that has adequate accuracy and instantaneousness (there are studies and experiments done with SEA – Series Elastic Actuators).

4. AUGMENTED SURGICAL INTERVENTION

CHALLENGE! New data-driven systems for supporting the planning and execution of the interventions to optimize outcomes and improve process efficiency.

  • Mechanical engineering
  • Robotics
  • Computational fluidodynamics
  • Sensorization and IoT
  • Industrial Engineering
  • Augmented reality
  • Physics and mathematics
  • Artificial intelligence
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Meditech area4 1

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IDEAS: The model may automatically generate the intervention plan (phases, instruments) given the type of prosthesis to be applied (which could be suggested based on ML – Machine Learning algorithms based on history), possibly generating different plans associated with different risk/success/cost information. The system may combine economic and usability aspects with gamification logics to maximize eagerness for surgeon across the County to annotate and share data from own interventions (e.g., by bringing labelling into the operating room to save time).

PROBLEM: At present, the whole planning of the operation (phases, instruments, as well as the type of suitable prosthesis) is done by the surgeon in a custom way. Some software exists and offers suggestions on selecting suitable stent diameters, but do not give advice on planning the operation. APSS is able to make available timed data of the various phases of an intervention in Daicom format (images with information on times, doses of drugs administered). Is it possible to think of a software capable of supporting the surgeon in planning the intervention, based on a database of planned interventions (and related outcomes)?

5. FUSION OF TOMOGRAPHY AND ECOGRAPHY SCAN DATA

CTA femoral artery run off image of femoral artery for diagnostic Acute or Chronic Peripheral Arterial Disease.

CTA femoral artery run off image of femoral artery for diagnostic Acute or Chronic Peripheral Arterial Disease.

CHALLENGE! Devise a technical solution that may be capable of tuning up and merging CT scan images with ECO scan images.

  • Mechanical engineering
  • Robotics
  • Computational fluidodynamics
  • Sensorization and IoT
  • Industrial Engineering
  • Augmented reality
  • Physics and mathematics
  • Artificial intelligence

IDEAS: In the post-operative phase, patients with a previous aneurysm are subjected to follow-up checks at three months and six months. The check-up visit involves the acquisition of CT images to verify the outcome of the surgery. It is assumed that CT data and images can be replaced by ultrasound scans capable of providing necessary and adequate information for these checks.

PROBLEM: At present it is important to verify the feasibility of a 3D rendering starting from ultrasound images fused with previous CT images of the patient. Being able to tune up and fuse the ultrasound images with the CT images can also prove useful during the intervention phase to reduce the radiation dose by completely or partially replacing the acquired RX images for intraoperative support to determine the positioning of the devices (catheter, guide, prosthesis) in the patient’s body.

6. HEMODYNAMIC COMPUTATIONAL MODELS FOR VASCULAR SURGERY

CHALLENGE! Explore whether specific choices on prosthesis properties may result in a reduction in the patient’s systolic blood pressure by means of using computational models.

  • Computational fluidodynamics
  • Anatomical models
  • Mechanical design of prosthetics
  • Physics and mathematics
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IDEAS: A team could study whether specific choices on prosthesis properties could result in a reduction in the patient’s systolic blood pressure. Furthermore, a team may investigate whether filling the aneurysm sac, with consequent increase in pressure external to the prosthesis, has a measurable impact on signals that can be acquired non-invasively (such as PPG) in order to develop a non-invasive monitoring method and continuous occurrence of endoleak.

PROBLEM: Previous studies highlight that abdominal aneurysm results in an increase in systolic blood pressure, resulting in overload of the left ventricle. Furthermore, recent studies highlight that the insertion of prostheses does not reduce high systolic blood pressure and furthermore increases other cardiovascular risk indicators such as Pulse Wave Velocity.

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Are you a company?

Are you a company in the medical device engineering and development sector? You can sponsor the Meditech Challenge.

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Are you a student?

Apply your skills in data science, robotics, material engineering, physics and mathematics, to team up with young vascular surgeons and tackle challenges in the field of vascular surgery.

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Are you a resident doctor?

Share your knowledge on clinical practice of vascular surgery and team up with young engineers to ideate solutions to technical challenges faced by vascular surgeons.

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The Meditech Challenge – Vascular surgery is an initiative organised by HIT – Hub Innovazione Trentino in collaboration with

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