scholarly journals Impact of network performance on remote robotic-assisted endovascular interventions in porcine model

2021 ◽  
Author(s):  
Peter Legeza ◽  
Gavin W. Britz ◽  
Alpesh Shah ◽  
Kalyna Sconzert ◽  
John-Michael Sungur ◽  
...  
Keyword(s):  
Network Performance ◽  
Porcine Model ◽  
External Carotid ◽  
Real Time Control ◽  
Robotic Assisted ◽  
Endovascular Interventions ◽  
Time Control ◽  
Network Latency ◽  
Endovascular Navigation

AbstractRemote robotic-assisted endovascular interventions require real-time control of the robotic system to conduct precise device navigation. The delay (latency) between the input command and the catheter response can be affected by factors such as network speed and distance. This study evaluated the effect of network latency on robotic-assisted endovascular navigation in three vascular beds using in-vivo experimental model. Three operators performed femoral, carotid, and coronary endovascular robotic navigation blinded from the hybrid room with the prototype remote-enabled CorPath GRX system in a porcine model. Navigation was performed to different targets with randomly assigned network latencies from 0 to 1000 ms. Outcome measurements included navigation success, navigation time, perceived lag (1 = imperceptible, 5 = too long), and procedural impact scored by the operators (1 = no impact, 5 = unacceptable). Robotic-assisted remote endovascular navigation was successful in all 65 cases (9 femoral, 38 external carotid, 18 coronary). Guidewire times were not significantly different across the simulated network latency times. Compared to 0 ms added latency, both the procedural impact and perceived lag scores were significantly higher when the added latency was 400 ms or greater (< 0.01). Remote endovascular intervention was feasible in all studied anatomic regions. Network latency of 400 ms or above is perceptible, although acceptable to operators, which suggests that remote robotic-assisted femoral, carotid or coronary arterial interventions should be performed with network latency below 400 ms to provide seamless remote device control.

scholarly journals Impact of Network Performance on Remote Robotic-assisted Endovascular Interventions in a Porcine Model

2020 ◽  
Vol 72 (1) ◽  
pp. e132-e133
Author(s):  
Peter Legeza ◽  
Gavin Britz ◽  
Shah Alpesh ◽  
Kalyna Sconzert ◽  
John-Michael Sungur ◽  
...  
Keyword(s):  
Network Performance ◽  
Porcine Model ◽  
Robotic Assisted ◽  
Endovascular Interventions

A new set of eyes: development of a novel microangioscope for neurointerventional surgery

2019 ◽  
Vol 11 (10) ◽  
pp. 1036-1039 ◽  
Author(s):  
Tyler Lazaro ◽  
Visish M Srinivasan ◽  
Phillip Cooper ◽  
Michael Phillips ◽  
Robert Garcia ◽  
...  
Keyword(s):  
Porcine Model ◽  
External Carotid Artery ◽  
External Carotid ◽  
Direct Visualization ◽  
Video Recordings ◽  
Technological Advances ◽  
Potential Applications ◽  
High Resolution Images ◽  
Fiber Optic Technology

BackgroundEndovascular technological advances have revolutionized the field of neurovascular surgery and have become the mainstay of treatment for many cerebrovascular pathologies. Digital subtraction angiography (DSA) is the ’gold standard' for visualization of the vasculature and deployment of endovascular devices. Nonetheless, with recent technological advances in optics, angioscopy has emerged as a potentially important adjunct to DSA. Angioscopy can offer direct visualization of the intracranial vasculature, and direct observation and inspection of device deployment. However, previous iterations of this technology have not been sufficiently miniaturized or practical for modern neurointerventional practice.ObjectiveTo describe the evolution, development, and design of a microangioscope that offers both high-quality direct visualization and the miniaturization necessary to navigate in the small intracranial vessels and provide examples of its potential applications in the diagnosis and treatment of cerebrovascular pathologies using an in vivo porcine model.MethodsIn this proof-of-concept study we introduce a novel microangioscope, designed from coherent fiber bundle technology. The microangioscope is smaller than any previously described angioscope, at 1.7 F, while maintaining high-resolution images. A porcine model is used to demonstrate the resolution of the images in vivo.ResultsVideo recordings of the microangioscope show the versatility of the camera mounted on different microcatheters and its ability to navigate external carotid artery branches. The microangioscope is also shown to be able to resolve the subtle differences between red and white thrombi in a porcine model.ConclusionA new microangioscope, based on miniaturized fiber optic technology, offers a potentially revolutionary way to visualize the intracranial vascular space.

scholarly journals Soft robotic steerable micro-catheter for the endovascular treatment of cerebral disorders

2021 ◽  
Author(s):  
Gopesh Tilvawala ◽  
Jessica H Wen ◽  
David Santiago-Dieppa ◽  
Bernard Yan ◽  
J. Scott Pannell ◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Porcine Model ◽  
Ease Of Use ◽  
Endovascular Intervention ◽  
Soft Robotics ◽  
Design Flexibility ◽  
Polymer Devices ◽  
Micro Catheter ◽  
Endovascular Navigation

Catheters used for endovascular navigation in interventional procedures lack dexterity at the distal tip. Neurointerventionists, in particular, encounter challenges in up to 25% of aneurysm cases largely due to the inability to steer and navigate the tip of the micro-catheters through tortuous vasculature to access aneurysms. We overcome this problem with sub-millimeter diameter, hydraulically-actuated hyperelastic polymer devices at the distal tip of micro-catheters to enable active steerability. Controlled by hand, the devices offer complete 3D orientation of the tip. Using pressures up to 400 kPa (4 atm) we demonstrate guidewire-free navigation, access, and coil deployment in vivo, offering safety, ease of use, and design flexibility absent in other approaches to endovascular intervention. We demonstrate the ability of our device to navigate through vessels and to deliver embolization coils to the cerebral vessels in a live porcine model. This indicates the potential for microhydraulic soft robotics to solve difficult access and treatment problems in endovascular intervention.

scholarly journals In-Vivo Real-Time Control of Protein Expression from Endogenous and Synthetic Gene Networks

2014 ◽  
Vol 10 (5) ◽  
pp. e1003625 ◽  
Author(s):  
Filippo Menolascina ◽  
Gianfranco Fiore ◽  
Emanuele Orabona ◽  
Luca De Stefano ◽  
Mike Ferry ◽  
...  
Keyword(s):  
Protein Expression ◽  
Real Time ◽  
Gene Networks ◽  
Synthetic Gene ◽  
Real Time Control ◽  
Synthetic Gene Networks ◽  
Time Control

scholarly journals Clinical Potential of Beat‐to‐Beat Diastolic Interval Control in Preventing Cardiac Arrhythmias

2021 ◽  
Author(s):  
Kanchan Kulkarni ◽  
Richard D. Walton ◽  
Antonis A. Armoundas ◽  
Elena G. Tolkacheva
Keyword(s):  
Real Time ◽  
Ex Vivo ◽  
Structural Complexity ◽  
Real Time Control ◽  
Comprehensive Overview ◽  
Cardiac Electrical Activity ◽  
Time Control ◽  
In Silico Studies ◽  
Diastolic Interval

Abstract Life‐threatening ventricular arrhythmias and sudden cardiac death are often preceded by cardiac alternans, a beat‐to‐beat oscillation in the T‐wave morphology or duration. However, given the spatiotemporal and structural complexity of the human heart, designing algorithms to effectively suppress alternans and prevent fatal rhythms is challenging. Recently, an antiarrhythmic constant diastolic interval pacing protocol was proposed and shown to be effective in suppressing alternans in 0‐, 1‐, and 2‐dimensional in silico studies as well as in ex vivo whole heart experiments. Herein, we provide a systematic review of the electrophysiological conditions and mechanisms that enable constant diastolic interval pacing to be an effective antiarrhythmic pacing strategy. We also demonstrate a successful translation of the constant diastolic interval pacing protocol into an ECG‐based real‐time control system capable of modulating beat‐to‐beat cardiac electrical activity and preventing alternans. Furthermore, we present evidence of the clinical utility of real‐time alternans suppression in reducing arrhythmia susceptibility in vivo. We provide a comprehensive overview of this promising pacing technique, which can potentially be translated into a clinically viable device that could radically improve the quality of life of patients experiencing abnormal cardiac rhythms.

scholarly journals Sonazoid-Conjugated Natural Killer Cells for Tumor Therapy and Real-Time Visualization by Ultrasound Imaging

Pharmaceutics ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1689
Author(s):  
Hyeong-Woo Song ◽  
Han-Sol Lee ◽  
Seok-Jae Kim ◽  
Ho Yong Kim ◽  
You Hee Choi ◽  
...  
Keyword(s):  
Nk Cells ◽  
Natural Killer ◽  
Real Time ◽  
Solid Tumors ◽  
Ultrasound Imaging ◽  
Tumor Therapy ◽  
Real Time Control ◽  
Time Control

Various cell therapy strategies, including chimeric antigen receptor-expressing T or natural killer (NK) cells and cell-mediated drug delivery, have been developed for tumor eradication. However, the efficiency of these strategies against solid tumors remains unclear. We hypothesized that real-time control and visualization of therapeutic cells, such as NK cells, would improve their therapeutic efficacy against solid tumors. In this study, we engineered Sonazoid microbubble-conjugated NK (NK_Sona) cells and demonstrated that they were detectable by ultrasound imaging in real-time and maintained their functions. The Sonazoid microbubbles on the cell membrane did not affect the cytotoxicity and viability of the NK cells in vitro. Additionally, the NK_Sona cells could be visualized by ultrasound imaging and inhibited tumor growth in vivo. Taken together, our findings demonstrate the feasibility of this new approach in the use of therapeutic cells, such as NK cells, against solid tumors.

A Real Time Control Architecture for Continuously Managing Patients in a Care Unit

1995 ◽  
Vol 34 (05) ◽  
pp. 475-488
Author(s):  
B. Seroussi ◽  
J. F. Boisvieux ◽  
V. Morice
Keyword(s):  
Real Time ◽  
Linear Time ◽  
Treatment Plan ◽  
Control Architecture ◽  
Real Time Control ◽  
Time Representation ◽  
Time Control ◽  
Continuous Support ◽  
Definition Of ◽  
Computerized System

Abstract:The monitoring and treatment of patients in a care unit is a complex task in which even the most experienced clinicians can make errors. A hemato-oncology department in which patients undergo chemotherapy asked for a computerized system able to provide intelligent and continuous support in this task. One issue in building such a system is the definition of a control architecture able to manage, in real time, a treatment plan containing prescriptions and protocols in which temporal constraints are expressed in various ways, that is, which supervises the treatment, including controlling the timely execution of prescriptions and suggesting modifications to the plan according to the patient’s evolving condition. The system to solve these issues, called SEPIA, has to manage the dynamic, processes involved in patient care. Its role is to generate, in real time, commands for the patient’s care (execution of tests, administration of drugs) from a plan, and to monitor the patient’s state so that it may propose actions updating the plan. The necessity of an explicit time representation is shown. We propose using a linear time structure towards the past, with precise and absolute dates, open towards the future, and with imprecise and relative dates. Temporal relative scales are introduced to facilitate knowledge representation and access.

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