Expert review of medical devices
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Expert Rev Med Devices · Sep 2014
ReviewThe lung volume reduction coil for the treatment of emphysema: a new therapy in development.
Lung volume reduction (LVR) coil treatment is a novel therapy for patients with severe emphysema. In this bilateral bronchoscopic treatment, approximately 10 LVR coils per lobe are delivered under fluoroscopic guidance in two sequential procedures. The LVR coil reduces lung volume by compressing the most destructed areas of the lung parenchyma and restores the lung elastic recoil. ⋯ The LVR-coil treatment has been evaluated in several European clinical trials since 2008 and received CE mark approval in 2010. Currently, two large multicenter randomized controlled trials are underway in Europe and North America to assess the efficacy and safety of the LVR-coil treatment at 12 months compared with usual care. In this review, we share our experience with the LVR-coil treatment.
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Evaluation of: Hampton DA, Lee TH, Diggs BJ, McCully SP, Schreiber MA. A predictive model of early mortality in trauma patients. Am. ⋯ This was incorporated with haemoglobin level, international normalized ratio, Glasgow Coma Score and the presence of penetrating injury to form their five-variable mortality prediction model. Hampton et al. conclude that the correlation between r-TEG measurements and trauma mortality makes it a useful tool in mortality prediction. The report highlights the importance of using this point-of-care coagulation assessment machine in mortality prediction for trauma patients.
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Expert Rev Med Devices · Jul 2014
ReviewHemodynamic impact of cerebral aneurysm endovascular treatment devices: coils and flow diverters.
Coils and flow diverters or stents are devices successfully used to treat cerebral aneurysms. Treatment aims to reduce intra-aneurysmal flow, thereby separating the aneurysmal sac from the blood circulation. ⋯ Summarizing findings on hemodynamic impact of treatment devices, we conclude: coiling and stenting do not affect post-treatment intra-aneurysmal pressure, but significantly alter aneurysmal hemodynamics through flow reduction and a change in flow structure. The impact of treatment devices on aneurysmal flow depends, however, on a set of parameters including device geometry, course of placement, parent vessel and aneurysm geometry.
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Expert Rev Med Devices · Jan 2014
EditorialA robot for transnasal surgery featuring needle-sized tentacle-like arms.
This paper discusses a new class of robots known as concentric tube robots and their application to transnasal skull base surgery. The endonasal approach has clear benefits for patients, but the surgery presents challenges that strongly motivate the use of robotic tools. In this paper, the concentric tube robot concept is described, and preliminary experimental results for transnasal skull base surgery are reviewed. Just as the da Vinci robot has revolutionized many laparoscopic surgeries, we expect concentric tube robots will enable the advancement of skull base surgery and the development of other minimally invasive procedures that require access through constrained paths.
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Expert Rev Med Devices · Nov 2013
ReviewFloTrac/Vigileo system monitoring in acute-care surgery: current and future trends.
As acute critical-care surgery evolves, it is imperative to introduce reliable devices that can intraoperatively assess a patient's cardiovascular functions. Owing to the fact that traditional methods are usually invasive, non- or less-invasive innovations have attracted the attention of clinicians in recent decades. The FloTrac system monitors cardiovascular performance by analyzing peripheral arterial waveforms and a preset database, and it decreases the invasiveness by using a pulmonary arterial catheter. ⋯ The accuracy of the latest third-generation algorithm is controversial in septic conditions, and its use is still unacceptable in liver transplantation. Due to vasoactive challenges, especially in the administration of norepinephrine, a conclusion could not be reached. Clinicians should recognize the appropriate uses and limitations when using the algorithm during acute critical surgeries.