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Design Innovation Paper

Development of an Alveolar Transbronchial Catheter for Concurrent Fiber Optics-Based Imaging and Fluid Delivery

[+] Author and Article Information
Nathan Knighton

Department of Bioengineering,
University of Utah,
36 S Wasatch Dr.,
Salt Lake City, UT 84112
e-mail: nate.knighton@utah.edu

Brian Cottle

Department of Bioengineering,
University of Utah,
36 S Wasatch Dr.,
Salt Lake City, UT 84112
e-mail: brian.k.cottle@utah.edu

Veronique Dentan

Mauna Kea Technologies,
9, rue d'Enghien,
Paris 75010, France
e-mail: veronique@maunakeatech.com

Tom Vercauteren

Wellcome/EPSRC Centre for Interventional and Surgical
Sciences,
University College London,
Charles Bell House 43-45 Foley Street,
London W1W 7TS, UK
e-mail: t.vercauteren@ucl.ac.uk

Ahsan Akram

EPSRC Proteus Hub,
MRC Centre for Inflammation Research,
The Queen's Medical Research Institute,
The University of Edinburgh,
47 Little France Crescent,
Edinburgh EH16 4TJ, UK
e-mail: ahsan.akram@ed.ac.uk

Annya Bruce

EPSRC Proteus Hub,
MRC Centre for Inflammation Research,
The Queen's Medical Research Institute,
The University of Edinburgh,
47 Little France Crescent,
Edinburgh EH16 4TJ, UK
e-mail: Annya.Bruce@ed.ac.uk

Kevin Dhaliwal

EPSRC Proteus Hub,
MRC Centre for Inflammation Research,
The Queen's Medical Research Institute,
The University of Edinburgh,
47 Little France Crescent,
Edinburgh EH16 4TJ, UK
e-mail: Kev.Dhaliwal@ed.ac.uk

Robert Hitchcock

Department of Bioengineering,
University of Utah,
36 S Wasatch Dr.,
Salt Lake City, UT 84112
e-mail: r.hitchcock@utah.edu

1Corresponding authors.

Manuscript received March 16, 2018; final manuscript received June 18, 2018; published online July 24, 2018. Assoc. Editor: Matthew R. Myers.

J. Med. Devices 12(3), 035003 (Jul 24, 2018) (9 pages) Paper No: MED-18-1057; doi: 10.1115/1.4040639 History: Received March 16, 2018; Revised June 18, 2018

Optical molecular imaging is an emerging field, and high-resolution optical imaging of the distal lung parenchyma has been made possible with the advent of clinically approved fiber-based imaging modalities. However, currently, there is no single method of allowing the simultaneous imaging and delivery of targeted molecular imaging agents. The objective of this research is to create a catheterized device capable of fulfilling this need. We describe the rationale, development, and validation in ex vivo ovine lung to near clinical readiness of a triple lumen bronchoscopy catheter that allows concurrent imaging and fluid delivery, with the aim of clinical use to deliver multiple fluorescent compounds to image alveolar pathology. Using this device, we were able to produce high-quality images of bacterial infiltrates in ex vivo ovine lung within 60 s of instilling a single microdose of (<100 mcg) imaging agent. This has many advantages for future clinical usage over the current state of the art.

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Figures

Grahic Jump Location
Fig. 3

Completed catheter prior to packaging and sterilization

Grahic Jump Location
Fig. 2

(a) Catheter cross section showing arrangement of lumens and (b) catheter hub showing extension tubes and luer connectors for fluid (top and bottom) and pCLE introduction (center)

Grahic Jump Location
Fig. 1

Device usage diagram. The TLBC is inserted via flexible bronchoscope and navigated to the region of interest. Imaging agent is then added, and the subject tissue analyzed. In the event, the tissue shows pathology requiring treatment, therapeutic liquids can then be applied. This is all accomplished without having to remove/reinsert catheter (original image from Wikipedia commons, modified by author).

Grahic Jump Location
Fig. 6

Flow test results. Submersion bubble testing indicated that all catheters with final pressure of ≤2.5 psi were prone to leakage, and catheters with final pressures in the range of 2.5–3.0 psi were suspect. No leakage was found in catheters where the pressure was ≥3.0 psi.

Grahic Jump Location
Fig. 4

(a) Triple lumen bronchoscopy catheter catheter under X-ray imaging in a chest algorithm. (b) The white depth marking bands are clearly visible using the integrated camera on the flexible bronchoscope.

Grahic Jump Location
Fig. 5

(a) Image of the distal end of TLBC with the AlveoFlex pCLE probe extended outside of the imaging lumen. Note that the probe shown here is a slightly damaged test sample used for fit-tests only. (b) Image of distal end of the TLBC illustrating the liquid flow through the 250 μm fluid lumens.

Grahic Jump Location
Fig. 7

Pressure decay testing results. Catheters with no leakage held constant pressure for the duration of the test (top). Lumen cross-talk leakage was identified by a sudden drop in pressure when the cap of an adjacent lumen was removed (second from top). Steady loss of pressure was associated with leakage through one of the joint regions of the assembly (bottom two).

Grahic Jump Location
Fig. 8

(a) Miniaturized AlveoFlex with TLBC in distal ovine lung without Fluorescent probe. (b) Image immediately following fluorescent probe administration, and (c) image following fluorescent probe dissipation. Bright areas show areas of bacterial infiltrates.

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