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

Icahn School Of Medicine At Mount Sinai, New York NY

Investigators

Abstract

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.