scholarly journals Steering Algorithm for a Flexible Microrobot to Enhance Guidewire Control in a Coronary Angioplasty Application

Micromachines ◽  
2018 ◽  
Vol 9 (12) ◽  
pp. 617 ◽  
Author(s):  
Ali Kafash Hoshiar ◽  
Sungwoong Jeon ◽  
Kangho Kim ◽  
Seungmin Lee ◽  
Jin-young Kim ◽  
...  
Keyword(s):  
Magnetic Field ◽  
Permanent Magnets ◽  
Three Dimensional ◽  
Coronary Intervention ◽  
Molding Method ◽  
Proposed Model ◽  
Percutaneous Coronary ◽  
Identification Approach ◽  
The Right ◽  
The Relationship

Magnetically driven microrobots have been widely studied for various biomedical applications in the past decade. An important application of these biomedical microrobots is heart disease treatment. In intravascular treatments, a particular challenge is the submillimeter-sized guidewire steering; this requires a new microrobotic approach. In this study, a flexible microrobot was fabricated by the replica molding method, which consists of three parts: (1) a flexible polydimethylsiloxane (PDMS) body, (2) two permanent magnets, and (3) a micro-spring connector. A mathematical model was developed to describe the relationship between the magnetic field and the deformation. A system identification approach and an algorithm were proposed for steering. The microrobot was fabricated, and the models for steering were experimentally validated under a magnetic field intensity of 15 mT. Limitations to control were identified, and the microrobot was steered in an arbitrary path using the proposed model. Furthermore, the flexible microrobot was steered using the guidewire within a three-dimensional (3D) transparent phantom of the right coronary artery filled with water, to show the potential application in a realistic environment. The flexible microrobot presented here showed promising results for enhancing guidewire steering in percutaneous coronary intervention (PCI).

scholarly journals Impact of Coronary Collateral Circulation on In-Hospital Death in Patients with Inferior ST Elevation Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Baris Yaylak ◽  
Bernas Altintas ◽  
Huseyin Ede ◽  
Erkan Baysal ◽  
Sukru Akyuz ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Collateral Circulation ◽  
Coronary Intervention ◽  
Hospital Death ◽  
Coronary Collateral Circulation ◽  
Coronary Collateral ◽  
Percutaneous Coronary ◽  
Angiographic Evidence ◽  
The Right ◽  
The Relationship

Objectives. Coronary collateral circulation (CCC) may limit the size of right ventricular (RV) infarcts but does not fully explain the relationship between CCC and clinical adverse events in patients with inferior STEMI. In this study, it was aimed to assess the relationship between preintervention angiographic evidence of CCC and clinical outcomes in patients with inferior STEMI who have undergone percutaneous coronary intervention.Methods. A total of 235 inferior STEMI patients who presented within the first 12 hours from the symptom onset were included. CCC to the right coronary artery (RCA) before angioplasty were angiographically assessed, establishing two groups: 147 (63%) patients without CCC and 88 (37%) with CCC according to presence of CCC.Results. RV infarction, complete atrioventricular block, VT/VF, cardiogenic shock, and in-hospital death were noted less frequently in patients with CCC than in those without CCC. Absence of CCC to RCA was found to be the independent predictor for in-hospital death among them (odds ratio 4.0, 95% CI 1.8–12.6;p=0.03).Conclusion. Presence of angiographically detectable CCC was associated with better in-hospital outcomes including RV infarction, complete AV block, cardiogenic shock, and VT/VF in patients with inferior STEMI.

scholarly journals Superficial temporal artery access for percutaneous coronary artery stenting during the COVID-19 pandemic: a case report

2020 ◽  
Author(s):  
Ádám Csavajda ◽  
Olivier F Bertrand ◽  
Béla Merkely ◽  
Zoltán Ruzsa
Keyword(s):  
Coronary Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Coronary Intervention ◽  
Femoral Access ◽  
St Segment Elevation ◽  
Invasive Cardiology ◽  
Percutaneous Coronary ◽  
Diagnostic Angiography ◽  
The Right

Abstract Background The COVID-19 pandemic creates new challenges for healthcare, including invasive cardiology. Case summary We discuss the case of a 65-year-old man who presented with non-ST segment elevation myocardial infarction combined with bilateral pneumonia. The patient had known severe iliac artery lesions with prior interventions and bilateral subclavian artery occlusions. After unsuccessful femoral artery access, the diagnostic angiography and the right coronary artery percutaneous coronary intervention were successfully performed from ultrasound-guided lower superficial temporal artery access. Discussion We showed that superficial temporal access can be used as an alternate access site for diagnostic coronary angiography and intervention when standard wrist and femoral access sites are not readily accessible.

P2426Validating the diagnostic value of a machine learning algorithm for STEMI detection

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Mehta ◽  
R Botelho ◽  
F Fernandez ◽  
C Villagran ◽  
A Frauenfelder ◽  
...  
Keyword(s):  
Medical Information ◽  
Learning Algorithm ◽  
Artery Bypass ◽  
Hospital Setting ◽  
Coronary Intervention ◽  
Diagnostic Value ◽  
Retrospective Case ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
The Right

Abstract Background We have previously reported the use of Artificial Intelligence (AI) guided EKG analysis for detection of ST-Elevation Myocardial Infarction (STEMI). To demonstrate the diagnostic value of our algorithm, we compared AI predictions with reports that were confirmed as STEMI. Purpose To demonstrate the absolute proficiency of AI for detecting STEMI in a standard12-lead EKG. Methods An observational, retrospective, case-control study. Sample: 5,087 EKG records, including 2,543 confirmed STEMI cases obtained via feedback from health centers following appropriate patient management (thrombolysis, primary Percutaneous Coronary Intervention (PCI), pharmacoinvasive therapy or coronary artery bypass surgery). Records excluded patient and medical information. The sample was derived from the International Telemedical Systems (ITMS) database. LUMENGT-AI Algorithm was employed. Preprocessing: detection of QRS complexes by wavelet system, segmentation of each EKG into individual heartbeats (53,667 total beats) with fixed window of 0.4s to the left and 0.9s to the right of main QRS; Classification: A 1-D convolutional neural network was implemented, “STEMI” and “Not-STEMI” classes were considered for each heartbeat, individual probabilities were aggregated to generate the final label for each record. Training & Testing: 90% and 10% of the sample were used, respectively. Experiments: Intel PC i7 8750H processor at 2.21GHz, 16GB RAM, Windows 10 OS with NVIDIA GTX 1070 GPU, 8GB RAM. Results The model yielded an accuracy of 97.2%, a sensitivity of 95.8%, and a specificity of 98.5%. Conclusion(s) Our AI-based algorithm can reliably diagnose STEMI and will preclude the role of a cardiologist for screening and diagnosis, especially in the pre-hospital setting.

The Relationship of Body Mass Index to Outcomes after Percutaneous Coronary Intervention

2006 ◽  
Vol 19 (5) ◽  
pp. 388-395 ◽  
Author(s):  
MAMDOUH M. SHUBAIR ◽  
POORNIMA PRABHAKARAN ◽  
VIKTORIA PAVLOVA ◽  
JAMES L. VELIANOU ◽  
ARYA M. SHARMA ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Percutaneous Coronary Intervention ◽  
Body Mass ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Relationship Of ◽  
The Relationship

scholarly journals A Voxel-Map Quantitative Analysis Approach for Atherosclerotic Noncalcified Plaques of the Coronary Artery Tree

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Ying Li ◽  
Wei Chen ◽  
Kaijun Liu ◽  
Yi Wu ◽  
Yonglin Chen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Three Dimensional ◽  
Coronary Intervention ◽  
Quantitative Information ◽  
Atherosclerotic Plaques ◽  
Anatomical Location ◽  
Contrast Enhanced ◽  
Percutaneous Coronary ◽  
Map Analysis ◽  
Coronary Artery Tree

Noncalcified plaques (NCPs) are associated with the presence of lipid-core plaques that are prone to rupture. Thus, it is important to detect and monitor the development of NCPs. Contrast-enhanced coronary Computed Tomography Angiography (CTA) is a potential imaging technique to identify atherosclerotic plaques in the whole coronary tree, but it fails to provide information about vessel walls. In order to overcome the limitations of coronary CTA and provide more meaningful quantitative information for percutaneous coronary intervention (PCI), we proposed a Voxel-Map based on mathematical morphology to quantitatively analyze the noncalcified plaques on a three-dimensional coronary artery wall model (3D-CAWM). This approach is a combination of Voxel-Map analysis techniques, plaque locating, and anatomical location related labeling, which show more detailed and comprehensive coronary tree wall visualization.

An Equivalent 3-D Method for Analyzing Orthogonally Stiffened Plate Structures

1987 ◽  
Vol 31 (02) ◽  
pp. 101-106
Author(s):  
Kyu Nam Cho ◽  
William S. Vorus
Keyword(s):  
Bridge Decks ◽  
Three Dimensional ◽  
Stiffened Plate ◽  
Plate Structures ◽  
Work Related ◽  
Beam Elements ◽  
Proposed Model ◽  
The Relationship

A new three-dimensional method is proposed for analyzing orthogonally stiffened grillage structures. The method is based on earlier work related to bridge decks. The relationship between system displacement and loads is described mathematically, and matrices are developed to examine the shear compatibility between plate and beam elements. The paper concludes with a comparison between deflections obtained by several different procedures and the proposed model.

Abstract 15990: Incidence and Outcomes of Elevated Troponins in Patients With Rhabdomyolysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nitheesha Ganta ◽  
Hilda Gonzalez ◽  
Olubode Olufajo ◽  
Prafulla P Mehrotra
Keyword(s):  
Hospital Mortality ◽  
Hospital Cost ◽  
Myocardial Injury ◽  
Case Reports ◽  
Coronary Intervention ◽  
Troponin Elevation ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Relationship ◽  
Cost Differences

Introduction: The relationship between rhabdomyolysis and elevated troponins has not been clearly established. Literature has been limited to case reports and small single center studies. However, there are no studies that evaluated the incidence and outcomes of troponin elevation in patients with rhabdomyolysis. Methods: Patients of 18 years and older with rhabdomyolysis were selected from the Healthcare Cost and Utilization Project National Inpatient Sample, 2005 to 2014. Patients with elevated troponins were identified. Information on demographics, co-morbidities and interventions (percutaneous coronary intervention (PCI) vs. no PCI) were extracted. The two main outcomes were mortality and hospital cost. Differences in characteristics and outcomes of patients with elevated troponins and those without elevated troponins were evaluated using descriptive analyses and multivariate regression models. Results: A total of 404,369 rhabdomyolysis participants were identified with 24,986 (6.18%) having elevated troponins. Of these, only 133 (0.03%) patients underwent PCI. Compared to the patients without elevated troponins, patients with elevated troponins were older (69y vs. 61y; P <0.001), and the majority were white (73.9% vs. 66.0%; P <0.001). In-hospital mortality in patients with elevated troponins was 20.5% compared to 5.4% in patients without elevated troponins ( P <0.001) resulting in an adjusted odds ratio of 4.05 (95% CI: 3.90 - 4.20). Compared to the patients without elevated troponins, the median hospital cost in patients with elevated troponins was $17,308 vs. $8,434 ( P <0.001) resulting in an adjusted mean difference of $9,547 (95% CI: $9,189 - $9,904). Conclusions: Our analysis showed that 6.1% of rhabdomyolysis patients have elevated troponins. Of these, very few patients underwent PCI, suggesting myocardial injury in these patients. Patients with elevated troponins had higher in-hospital mortality and increased cost of hospitalization. Due to the bad prognosis associated with elevated troponins, there is need for further evaluation for underlying coronary artery disease in patients with myocardial injury.

Vertical Disparity Can Alter Perceived Direction

Perception ◽  
10.1068/p3440 ◽  
2002 ◽  
Vol 31 (11) ◽  
pp. 1323-1333 ◽  
Author(s):  
Ellen M Berends ◽  
Raymond van Ee ◽  
Casper J Erkelens
Keyword(s):  
Three Dimensional ◽  
Visual Scene ◽  
Eye Position ◽  
Vertical Disparity ◽  
Vertical Scale ◽  
The Common ◽  
The Right ◽  
The Relationship ◽  
Straight Ahead ◽  
Stimulus Direction

It has been well established that vertical disparity is involved in perception of the three-dimensional layout of a visual scene. The goal of this paper was to examine whether vertical disparities can alter perceived direction. We dissociated the common relationship between vertical disparity and the stimulus direction by applying a vertical magnification to the image presented to one eye. We used a staircase paradigm to measure whether perceived straight-ahead depended on the amount of vertical magnification in the stimulus. Subjects judged whether a test dot was flashed to either the left or the right side of straight-ahead. We found that perceived straight-ahead did indeed depend on the amount of vertical magnification but only after subjects adapted (for 5 min) to vertical scale (and only in five out of nine subjects). We argue that vertical disparity is a factor in the calibration of the relationship between eye-position signals and perceived direction.

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