Expert review of medical devices
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Expert Rev Med Devices · Jan 2015
Meta Analysis Comparative StudyStand-alone interspinous spacer versus decompressive laminectomy for treatment of lumbar spinal stenosis.
To compare the two-year clinical outcomes of a prospective, randomized controlled trial of an FDA-approved interspinous spacer with the compilation of published findings from 19 studies of decompressive laminectomy for the treatment of lumbar spinal stenosis. ⋯ Both treatments provide effective and durable symptom relief of claudicant symptoms. This stand-alone interspinous spacer offers the patient a minimally invasive option with less surgical risk.
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Expert Rev Med Devices · Jan 2015
ReviewOutcomes of post-operative periprosthetic femur fracture around total hip arthroplasty: a review.
As the number of primary total hip arthroplasties increase over the next several decades so will the incidence of periprosthetic fractures around the femoral stem. Treatment can reliably be predicted using the Vancouver classification with internal fixation being indicated in fractures involving a stable implant and revision arthroplasty indicated in those with unstable prostheses. ⋯ The treatment of Vancouver C periprosthetic fractures continues to follow basic AO fixation principles with an emphasis on eliminating stress risers with adequate implant overlap and length. This review will focus on the risk factors and classification of these fractures, as well as highlight the treatment options for post-operative periprosthetic femoral fractures around a total hip arthroplasty.
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Expert Rev Med Devices · Jan 2015
ReviewThe Silk flow-diverter stent for endovascular treatment of intracranial aneurysms.
Flow diverter (FD) stents represent a new endovascular technique developed for the treatment of complex intracranial aneurysms (wide neck, fusiform, large, and giant aneurysms) that are challenging for classic endovascular techniques such as coiling, balloon-assisted coiling and stent-assisted coiling. Low porosity, high metal coverage, and high pore density are the main properties of FD stents. These properties induce hemodynamic changes redirecting the blood flow away from the aneurysm and into the parent artery leading to gradual thrombosis of the aneurysm. ⋯ This is considered as a paradigm shift compared to prior endovascular methods, which predominantly aimed at providing treatment inside the aneurysmal sac. This paper describes in detail the first released FD stent, the Silk flow-diverter stent (Balt Extrusion, Montmorency, France), its mechanism of action and deployment technique. It reviews the pertinent literature regarding safety, efficacy and potential risks and complications associated with the use of this stent.
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Expert Rev Med Devices · Jan 2015
EditorialThe TriGuard embolic deflection device for prevention of stroke and cerebral embolization during transcatheter aortic valve replacement.
The incidence of embolic ischemic cerebral events during transcatheter aortic valve implantation remains high. The effects range from clinically silent embolic lesions in the brain to severe disabling stroke. ⋯ The TriGuard embolic deflection device is a nitinol frame filter that is placed across all three aortic cerebral vessel ostia to prevent particles from entering the brain circulation during the procedure. The results of clinical studies suggest that this procedure can lead to a reduction of embolic events, and an improvement of neurocognitive function when compared with unprotected transcatheter aortic valve implantation.
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Expert Rev Med Devices · Jan 2015
Sterile working in ultrasonography: the use of dedicated ultrasound covers and sterile ultrasound gel.
Ultrasound is currently an important tool for diagnostic and interventional procedures. Ultrasound imaging provides significant advantages as compared to other imaging methods. The widespread use of ultrasound also carries the risk of drawbacks such as cross-infections. ⋯ The preparation of ultrasound probes with dedicated probe covers is a useful alternative for sterile working conditions. One ultrasound probe cover discussed in this paper is directly glued on to the ultrasound probe without the use of ultrasound coupling gel. By the use of sterile ultrasound coupling gel at the outer surface, additional effects on aseptic working conditions can be obtained.