curiousmedstudent
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Im a curious med student and have a dumb question/idea. Would it be possible to use a catheter to push a very small electrode through the blood stream, then make a very small cut in the blood vessel, pass the electrode through the vessel and place it near a brain area, and then somehow close the wound without any massive intracranial bleeding?
Have procedures like this ever been attempted? Is there really zero way to cut through a blood vessel and avoid a massive brain bleed?
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Ideas are only dumb until someone proves it works. You could theoretically, for example, place it in a very distal vessel and occlude it before piercing out into the adjacent brain. The bigger question is why go through the trouble?
@Focus, if you can insert an electrode via blood vessel, I would imagine this would allow for minimally invasible DBS. If I am understanding you correctly, you are saying that one could 1) occlude the vessel 2) cut through the vessel and insert the probe 4) close the wound and 5) "de-occlude" the vessel afterwards?
@Guest, I am aware of sentrodes but those are stents still within the blood vessel. They are very impressive for recording purposes but it would be awesome if one could use vasculature to access deep brain areas for stimulation.
It would be exciting if endovascular electrode implantation were possible, and perhaps even in an outpatient setting.
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What would be the power source? Mechanism of removal? Need for permanent antiplatelet treatment? DBS isn't a particularly morbid surgery so a lot of intertia to overcome when you could stroke someone out.
Focused ultrasound way more likely to compete with DBS, particularly in the elderly
This is a bad idea.
The issues Focus posed are all valid and enough to kill this idea, the power source issue alone is. But on top of that there is no way you could go safely travel through a blood vessel and repair it endovascularly. Any blood vessel that's big enough to safely canalize to deliver an electrode is not safe to sacrifice. The only way to "repair" the vessel would be to maybe place a stent which then you'll need AP for which adds another issue and even then doesn't immediately repair anything by any means, blood still flows through a stent immediately after placement occlusion takes weeks.
None of these even matter though because there's no amount of pre-clinical studies that would let an IRB approve you sacrificing an artery for an elective procedure. Also this "MIS-DBS" problem is being adequately solved by focused US ablation, and once the power supply issues are solved with battery sizes DBS will easily be same day procedures.
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Focused ultrasound sounds fascinating. I had no idea that mechanical stimulation could affect neuronal activity.
Ah ok, so it's not possible to repair a punctured blood vessel. Haha thank you for the feedback
