The Experts below are selected from a list of 18651 Experts worldwide ranked by ideXlab platform

M Denton - One of the best experts on this subject based on the ideXlab platform.

  • spinal cord protection in aortic Endovascular Surgery
    BJA: British Journal of Anaesthesia, 2016
    Co-Authors: David Scott, M Denton
    Abstract:

    Abstract A persistent neurological deficit, such as paraplegia or paraparesis, secondary to spinal cord injury remains one of the most feared complications of Surgery on the descending thoracic or abdominal aorta. This is despite sophisticated advances in imaging and the use of less invasive Endovascular procedures. Extensive fenestrated Endovascular aortic graft prostheses still carry a risk of spinal cord injury of up to 10%; thus, this risk should be identified and strategies implemented to protect the spinal cord and maintain perfusion. The patients at highest risk are those undergoing extensive thoracic aortic stenting including thoracic, abdominal, and pelvic vessels. Although many techniques are available, lumbar cerebrospinal fluid drainage remains the most frequent intervention, along with maintenance of perfusion pressure and possibly staged procedures to allow collateral vessel stabilization. Many questions remain regarding other technical aspects, spinal cord monitoring and cooling, pharmacological protection, and the optimal duration of interventions into the postoperative period.

Changwoo Ryu - One of the best experts on this subject based on the ideXlab platform.

David Scott - One of the best experts on this subject based on the ideXlab platform.

  • spinal cord protection in aortic Endovascular Surgery
    BJA: British Journal of Anaesthesia, 2016
    Co-Authors: David Scott, M Denton
    Abstract:

    Abstract A persistent neurological deficit, such as paraplegia or paraparesis, secondary to spinal cord injury remains one of the most feared complications of Surgery on the descending thoracic or abdominal aorta. This is despite sophisticated advances in imaging and the use of less invasive Endovascular procedures. Extensive fenestrated Endovascular aortic graft prostheses still carry a risk of spinal cord injury of up to 10%; thus, this risk should be identified and strategies implemented to protect the spinal cord and maintain perfusion. The patients at highest risk are those undergoing extensive thoracic aortic stenting including thoracic, abdominal, and pelvic vessels. Although many techniques are available, lumbar cerebrospinal fluid drainage remains the most frequent intervention, along with maintenance of perfusion pressure and possibly staged procedures to allow collateral vessel stabilization. Many questions remain regarding other technical aspects, spinal cord monitoring and cooling, pharmacological protection, and the optimal duration of interventions into the postoperative period.

Ikuo Takahashi - One of the best experts on this subject based on the ideXlab platform.

  • catheter insertion reference trajectory construction method using photoelastic stress analysis for quantification of respect for tissue during Endovascular Surgery simulation
    International Journal of Optomechatronics, 2011
    Co-Authors: Carlos Tercero, Seiichi Ikeda, Toshio Fukuda, Makoto Negoro, Fumihito Arai, Ikuo Takahashi
    Abstract:

    There is a need to develop quantitative evaluation for simulator based training in medicine. Photoelastic stress analysis can be used in human tissue modeling materials; this enables the development of simulators that measure respect for tissue. For applying this to Endovascular Surgery, first we present a model of saccular aneurism where stress variation during micro-coils deployment is measured, and then relying on a bi-planar vision system we measure a catheter trajectory and compare it to a reference trajectory considering respect for tissue. New photoelastic tissue modeling materials will expand the applications of this technology to other medical training domains.

  • Photoelastic stress analysis error quantification in vasculature models for robot feedback control
    2010 IEEE International Conference on Robotics and Automation, 2010
    Co-Authors: Carlos Tercero, Seiichi Ikeda, Motoki Matsushima, Toshio Fukuda, Makoto Negoro, Ikuo Takahashi
    Abstract:

    Real-time and accurate stress calculation in walls of vasculature is desired to provide catheter insertion robots of feedback control without changing the catheter stiffness and lumen. This feedback source has also applications in Endovascular Surgery simulation for human skills and medical tools evaluation. For that purpose we consider photoelastic effect, as birefringence produced by light retardation relates with the stress inside the photoelastic materials. In this research a polariscope was designed for urethane elastomer vasculature models, the photoelastic coefficient of urethane elastomer was measured, and the camera system was calibrated to quantify and reduce error of the measurement system. An average error of 3.6% was found for the pressure range of 70-189 mmHg inside the model of urethane elastomer, this enables to calculate accurately stress in vasculature models during Human Blood Pressure Simulation (HBPS). That way we will be able to compare in a closed loop stress produced by HBPS and by the catheter motion when manipulated by a robot.

  • human blood pressure simulation for photoelastic stress analysis in models of vasculature
    International Symposium on Micro-NanoMechatronics and Human Science, 2009
    Co-Authors: Carlos Tercero, Seiichi Ikeda, Motoki Matsushima, Toshio Fukuda, Makoto Negoro, Erick Tijerino, Ikuo Takahashi
    Abstract:

    The development of a numerical criterion to evaluate the stress on models of vasculature has applications in evaluation of human skills, robots and medical tools. This criterion will enable better medical training for Endovascular Surgery and the development of better medical techniques and tools. We propose to use the stress produced by human blood pressure simulation in the wall of the model of vasculature as this criterion; and to measure the principal component of stress magnitude using photoelastic effect. For that we simulated human blood pressure with a 5.6% of average error, we developed a shielded urethane model of vasculature enabling water circulation and avoiding plastic deformation with pressures below 182 mmHg. We developed software to calculate the stress of the model wall. Stress produced by human blood pressure simulation and a guide wire were compared numerically in four ranges.

Martin Bjorck - One of the best experts on this subject based on the ideXlab platform.

  • editor s choice management of the diseases of mesenteric arteries and veins
    European Journal of Vascular and Endovascular Surgery, 2017
    Co-Authors: Martin Bjorck, Gabor Menyhei, Tilo Kolbel, Mark J W Koelemay, Stefan Acosta, Bastos F Goncalves, Jeroen J Kolkman, T Lees, J H Lefevre, Gustavo S Oderich
    Abstract:

    DedicationThese guidelines are dedicated to Paola De Rango, University of Perugia, Italy. She participated very actively in the process of developing these guidelines, in particular the important chapters on chronic arterial and venous mesenteric ischaemia. Six days after the second meeting of the task force she died unexpectedly, to our great despair and loss. We honour her dedication and scientific integrity by completing these guidelines. Among many other commitments she was a very productive reviewer and an associate editor of this journal. You can read more about Paola's important contributions to science and to the vascular community in the April 2016 issue of the European Journal of Vascular and Endovascular Surgery. 1 Dr Paola De Rango, July 28, 1966 – February 21, 2016

  • editor s choice management of the diseases of mesenteric arteries and veins clinical practice guidelines of the european society of vascular Surgery esvs
    European Journal of Vascular and Endovascular Surgery, 2017
    Co-Authors: Martin Bjorck, Gabor Menyhei, Tilo Kolbel, Mark J W Koelemay, Stefan Acosta, Bastos F Goncalves, Jeroen J Kolkman, T Lees, J H Lefevre, Gustavo S Oderich
    Abstract:

    Dedication These guidelines are dedicated to Paola De Rango, University of Perugia, Italy. She participated very actively in the process of developing these guidelines, in particular the important chapters on chronic arterial and venous mesenteric ischaemia. Six days after the second meeting of the task force she died unexpectedly, to our great despair and loss. We honour her dedication and scientific integrity by completing these guidelines. Among many other commitments she was a very productive reviewer and an associate editor of this journal. You can read more about Paola's important contributions to science and to the vascular community in the April 2016 issue of the European Journal of Vascular and Endovascular Surgery. 1 Download : Download high-res image (56KB) Download : Download full-size image Dr Paola De Rango, July 28, 1966 – February 21, 2016

  • treatment of popliteal aneurysm by open and Endovascular Surgery a contemporary study of 592 procedures in sweden
    European Journal of Vascular and Endovascular Surgery, 2015
    Co-Authors: Anne Cervin, Stefan Acosta, J Tjarnstrom, Hans Ravn, Rebecka Hultgren, Martin Welander, Martin Bjorck
    Abstract:

    WHAT THIS STUDY ADDS Previous comparisons between open and Endovascular repair of popliteal aneurysms have focused on asymptomatic patients, and have short follow up. This study is strengthened by the fact that it is contemporary, population based, without any selection bias, reporting on all kinds of presentations, and has approximately 90% 1 year follow up data. It shows that Endovascular repair has significantly inferior results compared with open repair, in particular in the group of patients who present with acute ischaemia. We believe these results will make many vascular surgeons think twice before they treat patients Endovascularly in the future. Background: Popliteal aneurysm (PA) is traditionally treated by open repair (OR). Endovascular repair (ER) has become more common. The aim was to describe time trends and compare results (OR/ER). Methods: The Swedish vascular registry, Swedvasc, has a specific PA module. Data were collected (2008e2012) and supplemented with a specific protocol (response rate 99.1%). Data were compared with previously published data (1994e2002) from the same database. Results: The number of operations for PA was 15.7/million person-years (8.3 during 1994e2001). Of 592 interventions for PA (499 patients), 174 (29.4%) were treated for acute ischaemia, 13 (2.2%) for rupture, 105 (17.7%) for other symptoms, and 300 (50.7%) were asymptomatic (31.5% were treated for acute ischaemia, 1994e2002, p ¼ .58). There were no differences in background characteristics between OR and ER in the acute ischaemia group.The symptomatic and asymptomatic groups treated with ER were older (p ¼ .006, p < .001). ER increased 3.6 fold (4.7% 1994e2002, 16.7% 2008e2012, p ¼ .0001). Of those treated for acute ischaemia, a stent graft was used in 27 (16.4%). Secondary patency after ER was 70.4% at 30 days and 47.6% at 1 year, versus 93.1% and 86.8% after OR (p ¼ .001, <.001). The amputation rate at 30 days was 14.8% after ER, 3.7% after OR (p ¼ .022), and 17.4% and 6.8% at 1 year (p ¼ .098). A stent graft was used in 18.3% for asymptomatic PA. Secondary patency after ER was 94.5% at 30 days and 83.7% at 1 year, compared with 98.8% and 93.5% after OR (p ¼ .043 and 0.026). OR was performed with vein graft in 87.6% (395/451), with better primary and secondary patency at 1 year than prosthetic grafts (p ¼ .002 and <.001), and with a posterior approach in 20.8% (121/581). Conclusions: The number of operations for PA doubled while the indications remained similar. ER patency was inferior to OR, especially after treatment for acute ischaemia, and the amputation risk tended to be higher, despite similar pre-operative characteristics.