CDU

Mosquitoes – dreaded creatures. But funny the way nature often leads the way.

The Mosquito, a needle holder device that vibrates to help the cardiovascular surgeon break through blood vessels hardened by plaque, has been developed in a joint effort by Scottish Health Innovations (SHIL), a technology transfer organization, and Active Ultrasonics (La Chaux de Fonds, Switzerland).

The device is designed after – and therefore named for – the similar way a mosquito “posits his proboscis into the skin” to find its meal of blood, namely by vibrating to reach past the surface of a victim’s skin, according to Dr. Nigel McLean, business development manager at SHIL.

SHIL was established “only four years ago to help technology transfer and product development for ideas that emanate from the NHS [National Health Service] in Scotland,” McLean told Cardiovascular Device Update. “So, any public NHS hospital employee can, in Scotland,” work with SHIL to “identify ideas and evaluate them and invest in them and bring them to life.”

After conducting a web search and with the knowledge of the vascular surgeon, Richard Lerski, MD, affiliated with a hospital in Dundee, Scotland — which McLean said was very well known in vascular surgery — McLean had the idea for the device.

McLean said that the key problem for surgeons in this application lies in the fact that it is very difficult to suture blood vessels in any region of the heart where there is calcification, which McLean described as being “a bit like an eggshell ... very hard and brittle.”

Because of this, the calcification tends to damage the “very delicate [suture] needles” surgeons used in the heart, and for coronary heart bypass procedures, surgeons attempt to use as small a needle as possible.

“For obvious reasons, the smaller the hole, the less chance of [blood] seeping out of the hole,” McLean said. “And also, you want to have a small needle go through” any graft, if there is any artificial vessel used in a bypass procedure.

Because of this difficulty, needles of a larger size may have to be used to break through the calcification; however, these come with the problem of doing more damage to the heart than is appropriate for the procedure, he said. Sometimes, surgeons have to simply crush the vessel or suture in another part of the vessel.

“You want to suture where you clinically need to,” McLean said, not just where you can, “so, this is where the idea came from.”

The Mosquito prototype needle is powered by a small generator. The operator simply pushes a button, and the needle begins to vibrate to crack through the calcification in these highly delicate surgeries.

Suture needles are designed to be “curved like horseshoes” and are about one or two inches long. They’re typically held by tweezer-like devices. SHIL’s and Active Ultrasonics’ prototype is meant to fit onto what is currently available, only the needle is powered by a small generator. The operator simply pushes a button, and the needle begins to vibrate to crack through the calcification in these highly delicate surgeries.

The Mosquito is partially based on a similar cutting device by Active Ultrasonics, and powered by a “similar energy source” as the one used by SHIL.

Development of the Mosquito involved the clinical expertise and medical physics expertise from Dr. Lerski, while SHIL provided the funding and project management and Active Ultrasonics provided the “enabling technology,” McLean said.

Still, SHIL’s prototype will likely have to be adapted in its final development.

“But SHIL is to be credited with taking the initial design and putting it into practice,” he said.

SHIL said it is currently seeking a partner with a global distribution presence to manufacture and distribute the device worldwide.

The device fulfills a global need for breaking up vessel plague, but McLean noted that the problem is most prevalent in Western Europe and the U.S. due to the typical high-fat diet, with this then compounded by age. More than 12 million Americans suffer from coronary artery disease and up to 60% of these suffering from atherosclerosis.