scholarly journals Augmented Reality Forward Damage Control Procedures for Nonsurgeons: A Feasibility Demonstration

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 521-525 ◽  
Author(s):  
Tyler E Harris ◽  
Stephen F DeLellis ◽  
Jerry S Heneghan ◽  
Robert F Buckman ◽  
Geoffrey T Miller ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Iliac Artery ◽  
High Speed ◽  
Damage Control ◽  
External Iliac Artery ◽  
Satellite Networks ◽  
Control Procedure ◽  
Visual Axis ◽  
Control Procedures ◽  
Commercial Off The Shelf

Abstract Introduction This article presents an emerging capability to project damage control procedures far forward for situations where evacuation to a formal surgical team is delayed. Specifically, we demonstrate the plausibility of using a wearable augmented reality (AR) telestration device to guide a nonsurgeon through a damage control procedure. Methods A stand-alone, low-profile, commercial-off-the-shelf wearable AR display was utilized by a remotely located surgeon to synchronously guide a nonsurgeon through proximal control of the distal external iliac artery on a surgical manikin. The manikin wound pattern was selected to simulate a rapidly exsanguinating junctional hemorrhage not controllable by nonsurgical means. Results This capability demonstration displayed successful use of AR technology, telecommunication, and procedural training and guidance in a single test pilot. The assisted physician assistant was able to rapidly control the simulated external iliac artery injury on this model. The telestration system used was commercially available for use with available civilian cell phone, wireless and satellite networks, without the need for dedicated high-speed networks. Conclusions A nonsurgeon, using a wearable commercial on-visual-axis telestration system, successfully performed a damage control procedure, demonstrating the plausibility of this approach.

Adventitial Cystic Disease of the External Iliac Artery - A Case Report

Swiss Surgery ◽  
2001 ◽  
Vol 7 (2) ◽  
pp. 90-94 ◽  
Author(s):  
Heim ◽  
Rosso
Keyword(s):  
Case Report ◽  
Iliac Artery ◽  
External Iliac Artery ◽  
Cystic Disease ◽  
Adventitial Cystic Disease ◽  
Präoperative Abklärung

Die zystische Degeneration der Adventitia (ZAD) in der A.iliaca externa ist mit zehn in der Literatur beschriebenen Fällen ein seltenes Phänomen. Eine rasch auftretende, einseitige Ischämiesymptomatik bei jungen Patienten sollte daran denken lassen und eine erweiterte präoperative Abklärung zur Folge haben. Die klassische Therapie mit Gefässresektion und Veneninterponat wird seit jeher kontrovers diskutiert. Wir berichten über einen Fall mit rezidivfreiem Verlauf über drei Jahre nach Exarterektomie.

Endovascular Treatment of External Iliac Artery Injuries After Hip Arthroplasty

2003 ◽  
Vol 10 (3) ◽  
pp. 672-675 ◽  
Author(s):  
Roberto Adovasio ◽  
Fabio Pozzi Mucelli ◽  
Giovanni Lubrano ◽  
Cristiana Gasparini ◽  
Manuel Belgrano ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Hip Arthroplasty ◽  
Iliac Artery ◽  
External Iliac Artery

Assessment of Commercial Off-the-Shelf Tissue Adhesives for Sealing Military-Relevant Corneal Perforation Injuries

2021 ◽  
Author(s):  
Eric J Snider ◽  
Lauren E Cornell ◽  
Brandon M Gross ◽  
David O Zamora ◽  
Emily N Boice
Keyword(s):  
Intraocular Pressure ◽  
High Speed ◽  
Anterior Segment ◽  
Ocular Tissue ◽  
Corneal Tissue ◽  
Corneal Perforation ◽  
Tissue Adhesives ◽  
Open Globe ◽  
Wide Range ◽  
Commercial Off The Shelf

ABSTRACT Introduction Open-globe ocular injuries have increased in frequency in recent combat operations due to increased use of explosive weaponry. Unfortunately, open-globe injuries have one of the worst visual outcomes for the injured warfighter, often resulting in permanent loss of vision. To improve visual recovery, injuries need to be stabilized quickly following trauma, in order to restore intraocular pressure and create a watertight seal. Here, we assess four off-the-shelf (OTS), commercially available tissue adhesives for their ability to seal military-relevant corneal perforation injuries (CPIs). Materials and Methods Adhesives were assessed using an anterior segment inflation platform and a previously developed high-speed benchtop corneal puncture model, to create injuries in porcine eyes. After injury, adhesives were applied and injury stabilization was assessed by measuring outflow rate, ocular compliance, and burst pressure, followed by histological analysis. Results Tegaderm dressings and Dermabond skin adhesive most successfully sealed injuries in preliminary testing. Across a range of injury sizes and shapes, Tegaderm performed well in smaller injury sizes, less than 2 mm in diameter, but inadequately sealed large or complex injuries. Dermabond created a watertight seal capable of maintaining ocular tissue at physiological intraocular pressure for almost all injury shapes and sizes. However, application of the adhesive was inconsistent. Histologically, after removal of the Dermabond skin adhesive, the corneal epithelium was removed and oftentimes the epithelium surface penetrated into the wound and was adhered to inner stromal tissue. Conclusions Dermabond can stabilize a wide range of CPIs; however, application is variable, which may adversely impact the corneal tissue. Without addressing these limitations, no OTS adhesive tested herein can be directly translated to CPIs. This highlights the need for development of a biomaterial product to stabilize these injuries without causing ocular damage upon removal, thus improving the poor vision prognosis for the injured warfighter.

scholarly journals Association of changes of pulse wave velocity and augmentation index after isometric handgrip exercise with coronary lesion extent and revascularization

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Seong Taeg Kim ◽  
Yeekyoung Ko ◽  
Jong-Wook Beom ◽  
Ki Yung Boo ◽  
Jae-Geun Lee ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Iliac Artery ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Coronary Revascularization ◽  
External Iliac Artery ◽  
Handgrip Exercise ◽  
Isometric Handgrip ◽  
Isometric Handgrip Exercise

Abstract Background Arterial stiffness is associated with myocardial ischemia and incident coronary artery disease (CAD), and indexes of arterial stiffness are usually increased in patients with CAD. However, these indexes are often increased in elderly without CAD. Arterial stiffness in patients with CAD may become more evident after isometric handgrip exercise which increases systolic pressure and ventricular afterload. We investigated the association of the change of stiffness indexes after isometric handgrip exercise with the lesion extent of CAD and the necessity for coronary revascularization. Methods Patients who were scheduled a routine coronary angiography via a femoral artery were enrolled. Arterial waveforms were traced at aortic root and external iliac artery using coronary catheters at baseline and 3 min after handgrip exercise. Augmentation index (AIx) was measured on the recorded aortic pressure waveform, and pulse wave velocity (PWV) was calculated using the ECG-gated time difference of the upstroke of arterial waveforms and distance between aortic root and external iliac artery. Results Total 37 patients were evaluated. Both PWV and AIx increased after handgrip exercise. ΔPWV was significantly correlated with ΔAIx (r = 0.344, P = 0.037). Patients were divided into higher and lower ΔPWV or ΔAIx groups based on the median values of 0.4 m/sec and 3.3%, respectively. Patients with higher PWV had more 2- or 3-vessel CAD (69% vs. 27%, P = 0.034), and underwent percutaneous coronary intervention (PCI) more frequently (84% vs. 50%, P = 0.038), but higher ΔAIx was not associated with either the lesion extent or PCI. Area under curve (AUC) of ΔPWV in association with PCI by C-statistics was 0.70 (95% confidence interval [CI] 0.51–0.88; P = 0.056). In multiple logistic regression analysis, ΔPWV was significantly associated with PCI (odds ratio 7.78; 95% CI 1.26–48.02; P = 0.027). Conclusions Higher ΔPWV after isometric handgrip exercise was associated with the lesion extent of CAD and the necessity for coronary revascularization, but higher ΔAIx was not.

scholarly journals Isolated bilateral external iliac artery dissections with emotional stress

2021 ◽  
Author(s):  
Shun Kondo ◽  
Hiroyuki Osanai ◽  
Yusuke Sakamoto ◽  
Hiroto Uno ◽  
Kensuke Tagahara ◽  
...  
Keyword(s):  
Emotional Stress ◽  
Iliac Artery ◽  
External Iliac Artery

scholarly journals Treatment of an external iliac artery chronic total occlusion using alternate access sites

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Justin Ratcliffe ◽  
Mike Gorenchtein ◽  
Pankaj Khullar ◽  
Abel Casso Dominguez ◽  
Mohan Satish ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
External Iliac Artery ◽  
Arterial Disease ◽  
Patient Comfort ◽  
Vascular Lesions ◽  
Symptom Improvement ◽  
Total Occlusion ◽  
Maximal Medical Therapy ◽  
Peripheral Arterial

Abstract Background With the advent of endovascular techniques, alternate sites such as the pedal and radial arteries can now be accessed when treating peripheral arterial disease to reduce procedural complications, shorten recovery time, and improve patient comfort. However, a paucity of literature exists on the availability of support devices that can be utilized during challenging cases. Case presentation A 70 year-old female patient presented for evaluation of severe lifestyle-limiting left-sided claudication refractory to maximal medical therapy. Angiography revealed a chronic total occlusion of the left external iliac artery, which was treated successfully by percutaneous intervention via a primary transpedal approach and with the assistance of the Outback® Elite re-entry device. The patient was discharged 2 h after the procedure and reported significant symptom improvement at follow-up. Conclusion This case highlights a newly adopted endovascular approach through an alternate access site and illustrates how the Outback® Elite device can be used as an adjunctive tool in the treatment of complex lower-extremity vascular lesions.

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