CONTROL SYSTEM FOR NEEDLE INSERTION INTO THE PERIPHERAL VENOUS VESSEL

Предложен новый способ контроля введения инъекционной иглы в просвет вены на основе измерений электрического импеданса с помощью смешанной системы электродов, состоящей из биполярного и тетраполярного звеньев. Исследованы альтернативные схемы расположения электродов при проведении контроля венозной пункции биоимпедансным методом - они имеют более сложную конструкцию, используют дорогостоящие специализированные коаксиальные иглы, не позволяют однозначно определить факт прокола стенки венозного сосуда, нуждаются в дополнительной фильтрации регистрируемого сигнала с целью корректной интерпретации результата. Эффективность предложенной методики проверялась в ходе экспериментальных исследований на 5 добровольцах. Результаты экспериментов позволили идентифицировать 4 стадии нахождения инъекционной иглы относительно верхней конечности: нет касания, касание кожного покрова, нахождение под кожей коже, попадание в просвет вены. Идентификация положений инъекционной иглы происходит в реальном времени без дополнительной фильтрации регистрируемого сигнала. Метод позволяет обнаружить момент прокола стенки венозного сосуда стандартной инъекционной иглой, что в дальнейшем позволит сэкономить на изготовлении специализированных многослойных игольчатых электродов и внедрить данный способ контроля за проведением венепункции в медицинскую практику. Дальнейшее развитие предложенного подхода предполагает идентификацию двойного прокола вены, дифференцирование типа ткани в процессе введения иглы и исследование возможности определения типа кровеносного сосуда A new method for controlling the penetration of an injection needle into the vein based on measurements of electrical impedance using a mixed system of electrodes consisting of bipolar and tetrapolar parts is proposed. Alternative schemes for the arrangement of electrodes for monitoring venous puncture using the bioimpedance method have been investigated - they have a more complex design, use expensive specialized coaxial needles, do not allow to unambiguously determine the fact of a puncture of the venous vessel wall, require additional filtering of the recorded signal in order to correctly interpret the result. The effectiveness of the proposed technique was tested in experimental studies on 5 volunteers. The results of the experiments made it possible to identify 4 stages of finding the injection needle relative to the upper limb: no touching, touching the skin, being under the skin of the skin, getting into the lumen of the vein. Identification of the positions of the injection needle occurs in real time without additional filtering of the recorded signal. The method allows detecting the moment of puncture of the wall of a venous vessel with a standard injection needle, which in the future will save on the manufacture of specialized multilayer needle electrodes and introduce this method of monitoring venipuncture into medical practice. Further development of the proposed approach involves the identification of a double vein puncture, differentiation of tissue type during needle insertion, and investigation of the possibility of determining the type of blood vessel

Real-Time Impedance Detection of Intra-Articular Space in a Porcine Model Using a Monopolar Injection Needle

Rheumatoid arthritis and osteoarthritis can be treated through specific drug injection into the intra-articular space. Several failures during drug injection attempts with conventional fluoroscopy and ultrasonography in a small area of the intra-articular space have been reported. In this work we present an innovative impedance measurement-based method/algorithm for needle tip positioning to enhance image-guided intra-articular vaccination treatment. A novel algorithm for detecting the intra-articular space in the elbow and knee joints of a live porcine model is reported. An impedance measurement system was developed for biological tissue measurement. The electrical impedance in the intra-articular space was monitored and the needle tip was examined by ultrasonography. The contrast dye was vaccinated and checked using fluoroscopy to confirm that the dye was properly inoculated in the cavity. The electrical impedance was estimated for various needle inclusion profundity levels in saline solution, which were broadly used to evaluate the proposed device for in vivo examinations. Good efficiency was observed in the impedance-based measurements using a monopolar injection needle for intra-articular therapy. To enhance the needle tip positioning for intra-articular therapy, the intended impedance measurement device with a monopolar injection needle can be used as a complement to existing modalities.

1114 NSTEMI originated from an insulin injection needle

A fifty-eight-old previously healthy woman presented to the emergency department with chest pain radiating to the retrosternal area on her way to work. Initial ECG showed no ST-T segment change, but the troponin level was elevated. Urgent coronary angiography demonstrated normal coronary arteries. Ergonovine provocation was also undergone, and no coronary spasm was provoked. During angiography, a fine mobile artifact near the distal portion of left anterior descending artery was observed (Figure A and B, yellow arrow). Her chest wall was fully clear without recent injury. She didn"t receive any acupuncture treatment or is not an intravenous drug user. She is a factory worker making insulin injection needle. Echocardiography showed a hyperechogenic sharp foreign body penetrating interventricular septum with color jet (Figure C and D, yellow arrow). No pericardial effusion was observed. She underwent surgery to remove the foreign object. A fresh fine needle approximately 23 mm-long was entirely removed without extensive dissection under fluoroscopic guidance (Figure E and F). Her symptom was fully resolved after removing the needle and she discharged without further event. Abstract 1114 Figure.