Editors' ChoiceCardiology

Balloons with Brains

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Science Translational Medicine  27 Apr 2011:
Vol. 3, Issue 80, pp. 80ec62
DOI: 10.1126/scitranslmed.3002542

From animal entrails to a child’s toy, the evolution of the balloon continues to progress at an astounding rate. The current state of balloon technology as it pertains to biologic intervention is exemplified by the balloon catheter. This diverse set of medical devices is able to deliver powerful medications, open blocked arteries, freeze harmful tissues, and direct laser ablation, all through a small incision. The balloon-catheter device is configured through controlled inflation and can reach deep inside the brain or heart from remote areas such as the leg. In a paper by Kim et al., the next upgrade of balloon is introduced as an innovative smart balloon that uses high-performance semiconductor devices, sensors, actuators, and other components to transform a balloon catheter into a highly sophisticated “instrumented balloon” and next-generation high-tech surgical tool.

Kim et al. fabricated these instrumented balloons using a biocompatible noncoplanar serpentine mesh layout combined with pressure-sensitive, electrically conductive silicone rubber (PSR) overlying a rectangular feature of low-modulus formulation of poly(dimethylsiloxane). With these balloons, the authors were able to perform multiple balloon inflation and deflation cycles exceeding 100% strain levels with little or no performance degradation. A thin coating of polyimide (PI) cured at 300°C for an hour encapsulated the entire structure to prevent current leakage and was compatible with temperatures used for sterilization.

The authors then demonstrated the balloons’ ability to sense electrical, optical, temperature, and flow properties at the tissue-balloon interface, all in real time. They recorded cardiac electrophysiological, tactile, and temperature data in vivo in a rabbit heart. As an example, radiofrequency ablation coupled with temperature sensing was performed while tracking the absolute temperatures achieved during ablation. The authors hint at the further evolution of this technology by incorporating the same sensing capabilities into a surgeon’s glove. The concept of being able to put your hands directly on a patient’s heart during open-heart surgery and have the physiologic data “at your fingertips” is truly a novel concept that is quickly evolving into reality.

D.-H. Kim et al., Materials for multifunctional balloon catheters with capabilities in cardiac electrophysiological mapping and ablation therapy. Nat. Mater. 10, 316–323 (2011). [Abstract]

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