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https://www.readbyqxmd.com/read/28814045/across-user-adaptation-for-a-powered-lower-limb-prosthesis
#1
John A Spanias, Ann M Simon, Levi J Hargrove
Pattern recognition algorithms have been used to control powered lower limb prostheses because they are capable of identifying the intent of the amputee user and therefore can provide a method for seamlessly transitioning between the different locomotion modes of the prosthesis. However, one major limitation of current algorithms is that they require subject-specific data from the individual user. These data are difficult and time-consuming to collect and consequently these algorithms do not generalize well across users...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814001/design-of-an-energy-efficient-transfemoral-prosthesis-using-lockable-parallel-springs-and-electrical-energy-transfer
#2
Francois Heremans, Renaud Ronsse
Over the last decade, active lower-limb prostheses demonstrated their ability to restore a normal gait for transfemoral amputees by supplying the required positive energy balance [1]. However, the added-value of such devices is significantly impacted by their limited energetic autonomy preventing their full appropriation by the patients. There is thus a strong incentive to reduce the overall power consumption of active prostheses. Addressing this need requires to revisit the electromechanical design. For both the ankle and the knee, the present paper demonstrates that both the use of a lockable parallel spring and the transfer of electrical energy between joints can significantly improve the energetic performance for overground walking...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813983/modeling-and-control-of-a-transfemoral-prosthesis-embedding-two-infinitely-variable-transmissions
#3
Renaud Ronsse, Matthias Tummers, Christophe Everarts
In this paper, we report the model of an original actuation concept for a transfemoral prosthesis, relying on the combination of a single power motor, a compliant element (a spring), a mechanical differential, and two infinitely variable transmissions. It allows to manage the mechanical power flows through the device in both directions (i.e. when energy should be produced or dissipated by the knee and ankle), so that the power motor does not face the sharp load power fluctuations. The paper further reports a preliminary approach to synthesize a closed-loop controller for this device, and simulation results of this closed-loop behavior for three locomotion tasks: level-ground walking and stair ascent/descent...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813978/evaluation-of-3d-printed-anatomically-scalable-transfemoral-prosthetic-knee
#4
Tyagi Ramakrishnan, Millicent Schlafly, Kyle B Reed
This case study compares a transfemoral amputee's gait while using the existing Ossur Total Knee 2000 and our novel 3D printed anatomically scalable transfemoral prosthetic knee. The anatomically scalable transfemoral prosthetic knee is 3D printed out of a carbon-fiber and nylon composite that has a gear-mesh coupling with a hard-stop weight-actuated locking mechanism aided by a cross-linked four-bar spring mechanism. This design can be scaled using anatomical dimensions of a human femur and tibia to have a unique fit for each user...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28812396/the-influence-of-lower-limb-prostheses-technology-on-paracanoeing-time-trial-performance
#5
Shelley Ellis, Andrew Callaway, Bryce Dyer
Within the Paracanoeing discipline, it is important to ensure that appropriate control is achieved by a paddler with a disability. However, this Paralympic Games discipline has seen very little attention to date. The aims of this study were to understand the kinematic impact to a paracanoeist when not utilizing the use of a prosthetic lower-limb. A kayaker with a uni-lateral transfemoral amputation completed several 200 m maximal efforts both with and without their prosthesis. When the prosthetic limb was removed, there were significant differences found in stroke rate, stroke speed, stroke length and overall power output...
August 16, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28810990/gait-and-functional-outcomes-for-young-active-males-with-traumatic-unilateral-transfemoral-limb-loss
#6
Caitlin E Mahon, Alison L Pruziner, Brad D Hendershot, Erik J Wolf, Benjamin J Darter, K Bo Foreman, Joseph B Webster
OBJECTIVE: Altered body structures that occur with the loss of a lower limb can impact mobility and quality of life. Specifically, biomechanical changes that result from wearing a prosthesis have been associated with an increased risk of falls or joint degeneration, as well as increased energy demands. While previous studies describing these outcomes are typically limited by number of outcome measures and/or small, diverse patient groups, recent military conflicts present a unique opportunity to collect outcomes from a relatively homogenous, active patient population with limb loss...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28806252/quality-and-safety-in-health-care-part-xxx-transcatheter-aortic-valve-therapy
#7
Jay A Harolds
Initially, the transcatheter aortic valve replacement procedure was approved only for patients with aortic stenosis that was both severe and symptomatic who either also had too high a risk of aortic valve replacement surgery to have the surgery or who had a high risk for the surgery. Between the years 2012 and 2015, the death rate at 30 days declined from an initial rate of 7.5% to 4.6%. There has also been more use of the transfemoral approach over the years. In 2016, the transcatheter aortic valve replacement was approved for patients with aortic stenosis at intermediate risk of surgery...
August 12, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28802661/efficacy-of-isolated-limb-perfusion-ilp-in-patients-with-merkel-cell-carcinoma-mcc-a-multicenter-experience
#8
L M van Veenendaal, M F Madu, M E T Tesselaar, C Verhoef, D J Grünhagen, A C J van Akkooi
BACKGROUND: Merkel cell carcinoma (MCC) is a rare and potentially aggressive neuroendocrine tumor of the skin, with a propensity for locoregional metastases. In two expert referral centers, isolated limb perfusion (ILP) is used to obtain locoregional control in selected locoregionally advanced MCC patients. This study describes our experience. METHOD: Patients who underwent ILP for MCC were analyzed. ILP was performed with melphalan and tumor necrosis factor (TNF) combination therapy...
August 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28799113/angles-between-the-aortic-root-and-the-left-ventricle-assessed-by-mdct-are-associated-with-the-risk-of-aortic-regurgitation-after-transcatheter-aortic-valve-replacement
#9
Vincent Roule, Alexandre Placente, Rémi Sabatier, Mathieu Bignon, Vladimir Saplacan, Calin Ivascau, Paul Milliez, Farzin Beygui
OBJECTIVES: To evaluate the impact of the angles quantified by multidetector computed tomography (MDCT) between the ascending aorta's long axis and, the left ventricular inflow long axis (LVLA), or the left ventricule outflow tract long axis, and the occurrence of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR). METHODS: We prospectively included 136 consecutive patients who underwent a transfemoral TAVR with a preoperative MDCT. The groups were defined according to AR <2 or ≥2 assessed by echocardiography at 1 month...
August 10, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28797433/periprocedural-myocardial-injury-depends-on%C3%A2-transcatheter-heart-valve-type-but-does%C3%A2-not%C3%A2-predict-mortality-in-patients-after-transcatheter-aortic-valve-replacement
#10
Anja Stundl, Regina Schulte, Hannah Lucht, Marcel Weber, Alexander Sedaghat, Jasmin Shamekhi, Berndt Zur, Eberhard Grube, Fritz Mellert, Armin Welz, Rolf Fimmers, Georg Nickenig, Nikos Werner, Jan-Malte Sinning
OBJECTIVES: The aims of this study were to determine plasma elevations of biomarkers of myocardial injury associated with transfemoral (TF) transcatheter aortic valve replacement (TAVR) and to evaluate their prognostic value. BACKGROUND: Increases in biomarkers of myocardial injury are a common finding after TAVR, but their clinical significance is unclear. METHODS: In 756 consecutive TF TAVR patients, cardiac high-sensitivity troponin I (hsTnI) and creatine kinase MB (CK-MB) levels were measured at pre-defined time points to assess the occurrence of myocardial injury (defined as 15 times the upper reference limit for hsTnI [≥1...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28797431/implantation-and-30-day-follow-up-on-all%C3%A2-4-valve-sizes-within-the-portico-transcatheter-aortic-bioprosthetic-family
#11
Helge Möllmann, Axel Linke, David M Holzhey, Thomas Walther, Ganesh Manoharan, Ulrich Schäfer, Karl Heinz-Kuck, Ad J Van Boven, Simon R Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Stephen G Worthley
OBJECTIVES: The aim of this study was to evaluate the short-term safety and performance of the full range of valve sizes offered within the Portico transcatheter aortic valve replacement system. BACKGROUND: The Portico transcatheter aortic heart valve is a fully resheathable, repositionable, and self-expanding bioprosthesis designed to achieve optimal valve position and hemodynamic performance and limit conduction disturbances. METHODS: Patients (n = 222) with symptomatic (New York Heart Association functional class ≥II) severe aortic stenosis considered by a multidisciplinary heart team to be at high surgical risk were recruited between December 2011 and September 2015 in this prospective, nonrandomized, multicenter study...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28795259/comparison-of-outcomes-using-balloon-expandable-versus-self-expanding-transcatheter-prostheses-according-to-the-extent-of-aortic-valve-calcification
#12
Won-Keun Kim, Johannes Blumenstein, Christoph Liebetrau, Andreas Rolf, Luise Gaede, Arnaud Van Linden, Mani Arsalan, Mirko Doss, Jan G P Tijssen, Christian W Hamm, Thomas Walther, Helge Möllmann
BACKGROUND: Device landing zone (DLZ) calcification is an important determinant of procedural success in transcatheter aortic valve implantation (TAVI). OBJECTIVE: To evaluate the impact of DLZ calcification on procedural outcome with different types of transcatheter heart valves (THVs). METHODS: Aortic valve calcium density (AVCdens) was determined by non-contrast-enhanced computed tomography in 1232 patients undergoing transfemoral TAVI...
August 9, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28794812/endovascular-management-of-superior-mesenteric-artery-sma-aneurysm-adequate-access-is-essential-for-success-case-report
#13
Lovro Tkalčić, Berislav Budiselić, Miljenko Kovačević, Siniša Knežević, Slavica Kovačić, Damir Miletić, Vjekoslav Tomulić, Dimitrij Kuhelj
BACKGROUND: An aneurysm of the superior mesenteric artery (SMA) with a diameter of 2.2 cm was found incidentally on an ultrasound (US) examination in a 26-year-old woman. The only known risk factor was an intracranial aneurysm that was found on her grandmother's autopsy. Based on pregnancy planning and the current literature, endovascular management with a covered stent was proposed. CASE REPORT: Self-expandable, covered stent (Bard, Fluency(®)) was implanted using a single transfemoral approach...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28789844/impact-of-coronary-artery-disease-in-patients-undergoing-transfemoral-transcatheter-aortic-valve-implantation
#14
Jasmin Shamekhi, Anja Stundl, Marcel Weber, Fritz Mellert, Armin Welz, Eberhard Grube, Georg Nickenig, Nikos Werner, Jan-Malte Sinning
BACKGROUND: The impact of coronary artery disease (CAD) and revascularization on outcome in patients undergoing transcatheter aortic valve implantation (TAVI) has not been fully elucidated so far. OBJECTIVES: To assess whether the degree of CAD influences the prognosis of patients undergoing TAVI. METHODS: Before TAVI, all patients underwent revascularization of the proximal vessels or the left main stem if indicated (stenosis ≥70% or 50%, respectively)...
July 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28779858/transfemoral-transcatheter-aortic-valve-implantation-for-treatment-of-severe-aortic-regurgitation-in-a-patient-with-previous-aortic-valve-sparing-operation-according-to-david
#15
Luca Favero, Alessandro De Leo, Alessandro Daniotti, Diego Calzolari, Nicola Gasparetto, Giuseppe Minniti, Elvio Polesel, Zoran Olivari
The regurgitation of the native aortic valve in patient with previous David operation may represent a clinical challenge because the morbidity and mortality risk of re-operation is not negligible. Here we describe the case of a patient suffering from late severe aortic regurgitation, many years after David operation, efficaciously treated with transfemoral transcatheter aortic valve implantation. To the best of our knowledge, this is the first description of such treatment in a patient with aortic regurgitation and previous David operation...
July 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28777096/beam-projections-and-radiation-exposure-in-transradial-and-transfemoral-approaches-during-coronary-angiography
#16
Ali Tarighatnia, Amirhossien Mohammadalian, Morteza Ghojazade, Leili Pourafkari, Alireza Farajollahi
OBJECTIVE: We aimed to compare the operator and patient radiation exposure in standard projections during elective diagnostic coronary angiography procedures via transradial (TRA) versus transfemoral (TFA) approaches. METHODS: In this analytical cross-sectional study, a total of 202 consecutive patients who were candidates for diagnostic coronary angiography were randomized to undergo the procedure via TFA or TRA approaches (101 in each group). Patients with abnormal Allen test and history of coronary artery bypass surgery, valvular heart disease, and unsuccessful coronary angiography were excluded from the study...
August 2, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28763712/crossover-study-of-amputee-stair-ascent-and-descent-biomechanics-using-genium-and-c-leg-prostheses-with-comparison-to-non-amputee-control
#17
Derek J Lura, Matthew W Wernke, Stephanie L Carey, Jason T Kahle, Rebecca M Miro, M Jason Highsmith
This study was a randomized crossover of stair ambulation of Transfemoral Amputees (TFAs) using the Genium and C-Leg prosthetic knees. TFAs typically have difficulty ascending and descending stairs, limiting community mobility. The objective of this study was to determine the relative efficacy of the Genium and C-Leg prostheses for stair ascent and descent, and their absolute efficacy relative to non-amputees. Twenty TFAs, and five non-amputees participated in the study. TFAs were randomized to begin the study with the Genium or C-Leg prosthesis...
July 25, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28757286/transradial-versus-transfemoral-access-for-hepatic-chemoembolization-intrapatient-prospective-single-center-study
#18
Roberto Iezzi, Maurizio Pompili, Alessandro Posa, Eleonora Annicchiarico, Matteo Garcovich, Biagio Merlino, Elena Rodolfino, Vincenzo Di Noia, Michele Basso, Alessandra Cassano, Carlo Barone, Antonio Gasbarrini, Riccardo Manfredi, Cesare Colosimo
PURPOSE: To compare transfemoral approach (TFA) and transradial approach (TRA) in patients undergoing hepatic chemoembolization in terms of safety, feasibility, and procedural variables, including fluoroscopy time, radiation dose (reference air kerma [RAK]), and patient preference. MATERIALS AND METHODS: A single-center prospective intrapatient comparative study was conducted with 42 consecutive patients with hepatic malignancies who received 2 consecutive treatment sessions of unilobar hepatic chemoembolization within a 4-week interval over a 6-month period with both TRA and TFA...
July 27, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28756421/arterial-cutaneous-femoral-fistulous-tract-closure-using-surgiflo-hemostatic-matrix-a-novel-adjunct-for-post-tavr-access-site-management
#19
Eileen Gajo, Omer Iftikhar, Paul J Pearson, Ted Feldman, Mayra Guerrero, Justin Levisay, Michael H Salinger
Several options are available to address hemostasis at the end of a cardiac catheterization or percutaneous transfemoral transcatheter aortic valve replacement (TAVR) when conventional options are ineffective. To date, there have been few studies exploring the use of a topical thrombin preparation, as one of its main contraindications is that it cannot be used intravascularly due to risk of embolization. The following case shows safe utilization of Surgiflo hemostatic gel matrix under fluoroscopic guidance against an inflated balloon in order to achieve closure of a fistulous tract from a femoral artery access site during percutaneous TAVR...
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28748354/pressure-directed-embolization-of-hepatic-arteries-in-a-porcine-model-using-a-temporary-occlusion-balloon-microcatheter-proof-of-concept
#20
Steven C Rose, Gregory D Halstead, Kazim H Narsinh
PURPOSE: The purpose of this project was to test the hypothesis that temporary hepatic artery balloon occlusion would favorably alter the distribution of particle emboli within the targeted and nontargeted downstream vascular compartments. MATERIALS AND METHODS: Five Yorkshire pigs underwent transfemoral placement of balloon microcatheters into selected segmental hepatic arteries. A collection catheter was surgically introduced into a downstream hepatic artery branch...
July 26, 2017: Cardiovascular and Interventional Radiology
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