Endovascular procedures for cerebrovenous disorders

A teleoperated robotic catheter operating system is a solution to avoid occupational hazards caused by repeated exposure radiation of the surgeon to X-ray during the endovascular procedures. However, inadequate force feedback and collision detection while teleoperating surgical tools elevate the risk of endovascular procedures. Moreover, surgeons cannot control the force of the catheter/guidewire within a proper range, and thus the risk of blood vessel damage will increase. In this paper, a magnetorheological fluid (MR)-based robot-assisted catheter/guidewire surgery system has been developed, which uses the surgeon’s natural manipulation skills acquired through experience and uses haptic cues to generate collision detection to ensure surgical safety. We present tests for the performance evaluation regarding the teleoperation, the force measurement, and the collision detection with haptic cues. Results show that the system can track the desired position of the surgical tool and detect the relevant force event at the catheter. In addition, this method can more readily enable surgeons to distinguish whether the proximal force exceeds or meets the safety threshold of blood vessels.

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The Heartguard: A Humanitarian Pediatric Cardiac Surgery Program in Rural China

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0041-1723846 ◽

2021 ◽

Author(s):

Xun E. Zhang ◽

Zhi Geng ◽

Jun Shao ◽

Hao Yao ◽

Lu Wang ◽

...

Keyword(s):

Cardiac Surgery ◽

Endovascular Procedures ◽

Rural China ◽

Surgical Team ◽

Physical And Mental Health ◽

Team Members ◽

Financial Difficulties ◽

The Government ◽

Receive Treatment

Abstract Background Congenital heart disease (CHD) accounts for the most common birth defects in China, pressuring both the physical and mental health in children. The inaccessibility of CHD children in rural China due to financial difficulties is demanding inputs from both the government and society. The Heartguard project is a program developed to improve the delivery of CHD care in rural China. Methods The Heartguard project partners with county hospitals and performs CHD screening to diagnose patients with CHD in rural China. Diagnosed children with CHD who are unable to afford therapy will subsequently receive treatment sponsored by the financial partners. All patients are followed up by the local partner and visiting surgical team members. Results More than 10,000 children across 9 provinces underwent CHD screening. A total of 240 (accounting for an incidence of 2.4%) was treated by the program, of which 226 patients were managed invasively, the other 14 patients conservatively. Open surgery was performed in 162 patients, while endovascular procedures were applied in another 64. No mortality or significant complications occurred during the transfer. There was no perioperative or late death. Conclusion This humanitarian cardiac surgery program is able to promote accessibility of care for CHD children in rural China. The quality of life of these patients can be improved with continuous input from the society.

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Delayed leukoencephalopathy from suspected polymer embolism after neuroendovascular procedures

The Neuroradiology Journal ◽

10.1177/19714009211029172 ◽

2021 ◽

pp. 197140092110291

Author(s):

Thomas Mellemkjær ◽

Ronil V Chandra ◽

Lasse Speiser ◽

Benedicte P Ulhøi ◽

Claus Z Simonsen

Keyword(s):

Polymer Material ◽

Endovascular Procedures ◽

Rare Complication ◽

Diagnostic Process ◽

Line Treatment ◽

Review Of The Literature ◽

First Line ◽

Stroke Treatment ◽

Oral Glucocorticoids ◽

First Line Treatment

As the neurointervention field grows, a new side effect emerges. Delayed leukoencephalopathy (DL) is believed to be an inflammatory or allergic reaction to polymer material that is shed from catheters during endovascular procedures. We present four cases of DL after aneurysm treatment in two patients, endovascular stroke treatment and diagnostic arteriography. We present our diagnostic process, including biopsy results in two patients, our anti-inflammatory treatment and outcomes together with a review of the literature. In our series, prognosis was variable with ongoing seizures in two patients. Our literature review reveals that asymptomatic shedding of polymer material is common, occurring in a third of endovascular stroke procedures, whereas symptomatic DL occurs in <0.5% of therapeutic neuroendovascular procedures. Clinicians should be aware of this rare complication, and oral glucocorticoids seem to be a reasonable first-line treatment strategy.

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Safety Assessment of Continuous Versus Discontinuous Warfarin Therapy in Cardiovascular Endovascular Procedures: Observations from a Meta-analysis

10.1055/s-0041-1729833 ◽

2017 ◽

Author(s):

Nadia Hussain ◽

Amira Ahmed

Keyword(s):

Safety Assessment ◽

Warfarin Therapy ◽

Endovascular Procedures ◽

Meta Analysis

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Severe intracranial bleedings during endovascular procedures: outcome of surgically treated patients

Neurological Research ◽

10.1179/174313206x152492 ◽

2007 ◽

Vol 29 (1) ◽

pp. 81-90 ◽

Cited By ~ 12

Author(s):

Mario Carvi y Nievas ◽

Eberhard Haas ◽

Hans-Georg Höllerhage

Keyword(s):

Endovascular Procedures

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Retrieval of a migrated N-butyl-2 cyanoacrylate cast using a snare-kit system during dural AVF embolization: A case report

Interventional Neuroradiology ◽

10.1177/1591019918775957 ◽

2018 ◽

Vol 24 (5) ◽

pp. 571-573

Author(s):

Ramy Ahmed ◽

Satomi Ide ◽

Hiro Kiyosue ◽

Shuichi Tanoue ◽

Shunro Matsumoto ◽

...

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Endovascular Procedures ◽

Sigmoid Sinus ◽

Embolic Material ◽

Coagulation Profile ◽

Liquid Embolic

N-butyl-2 cyanoacrylate (NBCA) is a liquid embolic material that is widely used in various endovascular procedures because of its permanent and rapid vascular occluding effect regardless of the coagulation profile of the patient. However, NBCA migration to unintended vessels may result in serious complications. This report describes the retrieval of a migrated NBCA cast from the transverse-sigmoid sinus during dural arteriovenous fistula embolization using a transvenous snaring technique.

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