Aaron Henry, G. Goodchild, Jonathan B Greenwald, M. Meftah, Michael Moreno, Andrew B. Robbins
The goal of this work was to experimentally validate a computational model for TKRs to improve implant alignment accuracy and assess potential implant misalignment during preoperative planning. Initial validation of the model was achieved by comparing ligament strain energies between the computational model and a physical knee model comprised of bone and ligament analogues. Experimental validation would be considered met when the computational model strain energies were within 10% of the measured values for all six physical knees. Physical and computational knee models were created with six variations of implant alignment to test the robustness of the computational model. Strain energy errors were well within the 10% threshold across knee range of motion.
{"title":"EXPERIMENTAL VALIDATION OF A COMPUTATIONAL KNEE MODEL OF TKR IMPLANT PLACEMENT","authors":"Aaron Henry, G. Goodchild, Jonathan B Greenwald, M. Meftah, Michael Moreno, Andrew B. Robbins","doi":"10.1115/dmd2023-5598","DOIUrl":"https://doi.org/10.1115/dmd2023-5598","url":null,"abstract":"\u0000 The goal of this work was to experimentally validate a computational model for TKRs to improve implant alignment accuracy and assess potential implant misalignment during preoperative planning. Initial validation of the model was achieved by comparing ligament strain energies between the computational model and a physical knee model comprised of bone and ligament analogues. Experimental validation would be considered met when the computational model strain energies were within 10% of the measured values for all six physical knees. Physical and computational knee models were created with six variations of implant alignment to test the robustness of the computational model. Strain energy errors were well within the 10% threshold across knee range of motion.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131559954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Margaret Krieger, Aayod Kaul, Dailen C. Brown, Haroula M. Tzamaras, J. Moore, Scarlett R. Miller
A novel concept is proposed to effectively measure and train central venous catheter guidewire insertion. This system utilizes a 3D printed funnel to direct the insertion of a guidewire from multiple angles and positions. This directed guidewire can then be passed through previously developed sensors to provide the user with valuable training feedback. Experiments are performed to measure the effectiveness of the funnel system under varying insertion positions, angles, and funnel coatings. After experimentation, it was found that a funnel greased with white lithium grease allows the guidewire to successfully make it through the funnel compared to alternatives tested. This design will be applied to the Dynamic Haptic Robotic Trainer Plus (DHRT+) system to train medical residents to safely perform central venous catheterization.
提出了一种有效测量和训练中心静脉导管导丝插入的新方法。该系统利用3D打印漏斗从多个角度和位置引导导丝的插入。这种定向导丝可以通过以前开发的传感器，为用户提供有价值的培训反馈。在不同的插入位置、角度和漏斗涂层下，进行了实验来测量漏斗系统的有效性。实验后发现，与测试的替代方案相比，涂有白色锂脂的漏斗可以使导丝成功通过漏斗。该设计将应用于Dynamic Haptic Robotic Trainer Plus (DHRT+)系统，用于培训住院医生安全进行中心静脉置管。
{"title":"DESIGN OF AN INSERTION FUNNEL FOR A TRAINING SYSTEM FOR CENTRAL VENOUS CATHETER GUIDEWIRE INSERTION","authors":"Margaret Krieger, Aayod Kaul, Dailen C. Brown, Haroula M. Tzamaras, J. Moore, Scarlett R. Miller","doi":"10.1115/dmd2023-7767","DOIUrl":"https://doi.org/10.1115/dmd2023-7767","url":null,"abstract":"\u0000 A novel concept is proposed to effectively measure and train central venous catheter guidewire insertion. This system utilizes a 3D printed funnel to direct the insertion of a guidewire from multiple angles and positions. This directed guidewire can then be passed through previously developed sensors to provide the user with valuable training feedback. Experiments are performed to measure the effectiveness of the funnel system under varying insertion positions, angles, and funnel coatings. After experimentation, it was found that a funnel greased with white lithium grease allows the guidewire to successfully make it through the funnel compared to alternatives tested. This design will be applied to the Dynamic Haptic Robotic Trainer Plus (DHRT+) system to train medical residents to safely perform central venous catheterization.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131947802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xerostomia is the perception of oral dryness. In addition to discomfort, xerostomia can lead to several long-term medical complications within the oral cavity and gastrointestinal system. Treatment options are limited and are either not effective or not convenient for all people with xerostomia. In this study, we designed, tested, and further developed an oral mouth guard insert with electrodes for stimulating the lingual nerve on the medial side of the lower jawbone. Saliva production, collected in the context of randomized on/off testing with a subject blinded to the test condition, resulted in significantly more saliva output during and following lingual stimulation (2.07 g over one minute) versus off stimulation control conditions (1.58 g also over one minute) (two-sample t-test, p=0.001). The proof-of-concept prototype is poised for further refinement with system integration and improvement in packaging. Xerostomia is a common medical condition, and non-implantable devices that can increase salivation on-demand hold significant promise for treating xerostomia in the broader public.
{"title":"STIMULATION OF THE LINGUAL NERVE FOR INCREASED SALIVA OUTPUT","authors":"N. Johnson, Matthew D. Johnson","doi":"10.1115/dmd2023-9277","DOIUrl":"https://doi.org/10.1115/dmd2023-9277","url":null,"abstract":"\u0000 Xerostomia is the perception of oral dryness. In addition to discomfort, xerostomia can lead to several long-term medical complications within the oral cavity and gastrointestinal system. Treatment options are limited and are either not effective or not convenient for all people with xerostomia. In this study, we designed, tested, and further developed an oral mouth guard insert with electrodes for stimulating the lingual nerve on the medial side of the lower jawbone. Saliva production, collected in the context of randomized on/off testing with a subject blinded to the test condition, resulted in significantly more saliva output during and following lingual stimulation (2.07 g over one minute) versus off stimulation control conditions (1.58 g also over one minute) (two-sample t-test, p=0.001). The proof-of-concept prototype is poised for further refinement with system integration and improvement in packaging. Xerostomia is a common medical condition, and non-implantable devices that can increase salivation on-demand hold significant promise for treating xerostomia in the broader public.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123916146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over 34.2M Americans have diabetes and $237B is spent on direct costs of diabetes each year. Of this, $15B is spent on foot ulcer treatment alone as more than half of people with diabetes develop some type of neuropathy, the primary modifiable risk factor of ulcers in this population. Currently, patients with diabetic peripheral neuropathy (DPN) rely on early hotspot identification, padded soles, offloading boots, and diabetic shoes, with compliance being the major issue. Through expert interviews, there is a need for a better method to slow and prevent the progression of hot spots and other complications in patients with DPN. Our team is proposing DiaSense, a wearable device that replaces the lost sensation of pain with a safe and actionable stimulus that modifies gait to offload hotspots. The discrete design was guided by experiences from patients, podiatrists, and vascular surgeons to improve patient compliance, satisfaction, and recovery. Early user-feedback demonstrated useful validation that our device modifies walking behavior in healthy participants, and helps justify a larger study with patients who have diabetic peripheral neuropathy.
{"title":"PREVENTING THE PROGRESSION OF DIABETIC FOOT ULCERS: ADDRESSING PATIENT COMPLIANCE WITH LOW-COST, BEHAVIOR-MODIFYING WEARABLES","authors":"Carine Rizk, Koby Reid, K. Tran, Hannah Bass","doi":"10.1115/dmd2023-7569","DOIUrl":"https://doi.org/10.1115/dmd2023-7569","url":null,"abstract":"\u0000 Over 34.2M Americans have diabetes and $237B is spent on direct costs of diabetes each year. Of this, $15B is spent on foot ulcer treatment alone as more than half of people with diabetes develop some type of neuropathy, the primary modifiable risk factor of ulcers in this population. Currently, patients with diabetic peripheral neuropathy (DPN) rely on early hotspot identification, padded soles, offloading boots, and diabetic shoes, with compliance being the major issue. Through expert interviews, there is a need for a better method to slow and prevent the progression of hot spots and other complications in patients with DPN. Our team is proposing DiaSense, a wearable device that replaces the lost sensation of pain with a safe and actionable stimulus that modifies gait to offload hotspots. The discrete design was guided by experiences from patients, podiatrists, and vascular surgeons to improve patient compliance, satisfaction, and recovery. Early user-feedback demonstrated useful validation that our device modifies walking behavior in healthy participants, and helps justify a larger study with patients who have diabetic peripheral neuropathy.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125844329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Connor Huxman, G. Lewis, Gary F. Updegrove, April D. Armstrong, Jared Butler
In this work, we introduce a novel compliant fracture fixation plate capable of delivering controlled axial micromotion to a diaphyseal fracture. When an appropriate amount of interfragmentary strain is achieved, this micromotion is known to facilitate secondary healing by callus formation. The proposed single-piece designs leverage mechanical compliance to achieve motion, eliminating friction, wear, and detailed assembly inherent to other multi-component concepts. 3-dimensional simulations are carried out under offset axial loading. Initial finite element analysis results suggest that flexure-based compliant plates can achieve increased magnitude and symmetry of axial interfragmentary strain, even when constructed of stainless steel, a surgeon-preferred material that traditionally may be too stiff to promote callus formation.
{"title":"A COMPLIANT FRACTURE FIXATION PLATE FOR CONTROLLED AXIAL MOTION IN LONG BONE HEALING","authors":"Connor Huxman, G. Lewis, Gary F. Updegrove, April D. Armstrong, Jared Butler","doi":"10.1115/dmd2023-8517","DOIUrl":"https://doi.org/10.1115/dmd2023-8517","url":null,"abstract":"\u0000 In this work, we introduce a novel compliant fracture fixation plate capable of delivering controlled axial micromotion to a diaphyseal fracture. When an appropriate amount of interfragmentary strain is achieved, this micromotion is known to facilitate secondary healing by callus formation. The proposed single-piece designs leverage mechanical compliance to achieve motion, eliminating friction, wear, and detailed assembly inherent to other multi-component concepts. 3-dimensional simulations are carried out under offset axial loading. Initial finite element analysis results suggest that flexure-based compliant plates can achieve increased magnitude and symmetry of axial interfragmentary strain, even when constructed of stainless steel, a surgeon-preferred material that traditionally may be too stiff to promote callus formation.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130506382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Poulami Samaddar, Tasin Nusrat, Sunil Gaddam, C. Leggett, S. Dey, Dipankar Mitra, Sayan Roy, S. P. Arunachalam
Designing an effective antenna is very important to utilize microwave imaging. A high gain antipodal antenna designed with ultra-wideband frequency range is presented here. The simulated results are validated with measured data. The antenna can operate within the Ultra band frequency range of 3 to 8 GHz. The maximum gain of 2.96 dBi is obtained at 4 GHz. An experiment with biological tissues is also done to show the effectiveness of the antenna using as a resonator.
{"title":"ON THE DESIGN OF ULTRA-WIDE BAND ANTIPODAL VIVALDI ANTENNA FOR BIOMEDICAL SENSORS","authors":"Poulami Samaddar, Tasin Nusrat, Sunil Gaddam, C. Leggett, S. Dey, Dipankar Mitra, Sayan Roy, S. P. Arunachalam","doi":"10.1115/dmd2023-2982","DOIUrl":"https://doi.org/10.1115/dmd2023-2982","url":null,"abstract":"\u0000 Designing an effective antenna is very important to utilize microwave imaging. A high gain antipodal antenna designed with ultra-wideband frequency range is presented here. The simulated results are validated with measured data. The antenna can operate within the Ultra band frequency range of 3 to 8 GHz. The maximum gain of 2.96 dBi is obtained at 4 GHz. An experiment with biological tissues is also done to show the effectiveness of the antenna using as a resonator.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114961893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sam Carlson, Farhanuddin Fazaluddin Kazi, Abigail R. Clarke-Sather, Jomara Sandbulte, Sonya Wang
Kangaroo care is a vital component of infant care that can lead to reduced morbidity and mortality amongst infants born prematurely. While it is known that kangaroo care, or more simply, skin-to-skin contact, can lead to better health outcomes for both the infant and the mother, the correlation between duration of kangaroo care and positive health outcomes remains a mystery. Not all mothers are able to perform kangaroo mother care, or 24-hour kangaroo care, so it is important to know how much kangaroo care is necessary to achieve positive health outcomes for infants born prematurely. To determine the relationship between maternal-infant interactions, a system of health monitoring devices is presented to measure the duration and frequency of kangaroo care, along with the effects of kangaroo care before, during, and after the act. One specific parameter of interest is the heartrate of the mother and infant. The maternal heartrate can be measured with a commercially available Garmin Venu® Sq smartwatch, but it typically cannot be worn on the wrist in NICUs due to their infection control guidelines. The viability of wearing a Garmin® smartwatch to measure maternal heartrate on the ankle or bicep compared to the wrist was determined by wearing three smartwatches simultaneously on the specified locations. It was found that the smartwatch located at the ankle undercounted the heartrate by an average of 0.5 bpm and the smartwatch located at the bicep overcounted by an average of 0.05 bpm. From statistical analysis, it was determined that the smartwatch worn at the bicep would be an acceptable alternative to wearing a smartwatch on the wrist to gather maternal heartrate data for use in the complete kangaroo care monitoring system.
{"title":"INITIAL COMPARISON OF VITAL SIGNS MONITORING ON THE WRIST WITH THE ANKLE AND BICEP","authors":"Sam Carlson, Farhanuddin Fazaluddin Kazi, Abigail R. Clarke-Sather, Jomara Sandbulte, Sonya Wang","doi":"10.1115/dmd2023-6390","DOIUrl":"https://doi.org/10.1115/dmd2023-6390","url":null,"abstract":"\u0000 Kangaroo care is a vital component of infant care that can lead to reduced morbidity and mortality amongst infants born prematurely. While it is known that kangaroo care, or more simply, skin-to-skin contact, can lead to better health outcomes for both the infant and the mother, the correlation between duration of kangaroo care and positive health outcomes remains a mystery. Not all mothers are able to perform kangaroo mother care, or 24-hour kangaroo care, so it is important to know how much kangaroo care is necessary to achieve positive health outcomes for infants born prematurely. To determine the relationship between maternal-infant interactions, a system of health monitoring devices is presented to measure the duration and frequency of kangaroo care, along with the effects of kangaroo care before, during, and after the act. One specific parameter of interest is the heartrate of the mother and infant. The maternal heartrate can be measured with a commercially available Garmin Venu® Sq smartwatch, but it typically cannot be worn on the wrist in NICUs due to their infection control guidelines. The viability of wearing a Garmin® smartwatch to measure maternal heartrate on the ankle or bicep compared to the wrist was determined by wearing three smartwatches simultaneously on the specified locations. It was found that the smartwatch located at the ankle undercounted the heartrate by an average of 0.5 bpm and the smartwatch located at the bicep overcounted by an average of 0.05 bpm. From statistical analysis, it was determined that the smartwatch worn at the bicep would be an acceptable alternative to wearing a smartwatch on the wrist to gather maternal heartrate data for use in the complete kangaroo care monitoring system.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"149 11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130150309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew Baysa, Noah Turoski, Manilyn Cabrera, Yen-Lin Han
Stroke is a leading cause of mobility impairments. As more people suffer from stroke, there is a growing need for rehabilitation. Rehabilitation robots have been proven effective in assisting patients in their rehabilitation process. However, many existing rehabilitation robots are costly, so the accessibility to patients in need is limited. Soft robot technology has great potential to make rehabilitation more accessible. This paper presents a proof-of-concept soft robot design that could be used for finger rehabilitation, especially for those who suffer from clenched fists after a stroke. Using silicone elastomer and pneumatic actuation, we successfully fabricated a soft robot that curled in its resting state to fit under the patient’s clenched fist and straightened when actuated by compressed air to push the patient’s fingers open. With a unique approach to bonding the two-layer silicone elastomer structure, our soft robot can change shape to straight from its original curling state with a small air pressure (2 to 3 psi). Preliminary testing results demonstrate our soft robot’s functionality and provide valuable insights for us to optimize our design further to reach our eventual goal as a rehabilitation device that assists finger rehabilitation.
{"title":"“EXTENSOR” SOFT ROBOT FOR CLENCHED FIST REHABILITATION AFTER STROKE","authors":"Matthew Baysa, Noah Turoski, Manilyn Cabrera, Yen-Lin Han","doi":"10.1115/dmd2023-4176","DOIUrl":"https://doi.org/10.1115/dmd2023-4176","url":null,"abstract":"\u0000 Stroke is a leading cause of mobility impairments. As more people suffer from stroke, there is a growing need for rehabilitation. Rehabilitation robots have been proven effective in assisting patients in their rehabilitation process. However, many existing rehabilitation robots are costly, so the accessibility to patients in need is limited. Soft robot technology has great potential to make rehabilitation more accessible. This paper presents a proof-of-concept soft robot design that could be used for finger rehabilitation, especially for those who suffer from clenched fists after a stroke. Using silicone elastomer and pneumatic actuation, we successfully fabricated a soft robot that curled in its resting state to fit under the patient’s clenched fist and straightened when actuated by compressed air to push the patient’s fingers open. With a unique approach to bonding the two-layer silicone elastomer structure, our soft robot can change shape to straight from its original curling state with a small air pressure (2 to 3 psi). Preliminary testing results demonstrate our soft robot’s functionality and provide valuable insights for us to optimize our design further to reach our eventual goal as a rehabilitation device that assists finger rehabilitation.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128614663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A novel biomechanical guidance system (BGS) for markerless intra-operative bone tracking that seamlessly integrates into the surgical setting was recently developed [1]. It utilizes 3D models from pre-operative CT, via 3D-to-2D registration methods, to update object poses based on 2D fluoroscopic images. However, on occasion pre-operative CT images may be unavailable. We developed a CT-free method to enable BGS use that leverages neural radiance fields (NeRF) to generate a continuous volumetric scene [2,3] from intra-operative fluoroscopy. For proof of concept, digitally reconstructed radiographs (DRRs) were created from pelvic CT data as a stand-in for intra-operative fluoroscopy. DRRs and virtual C-arm positions were fed into an existing NeRF scene reconstruction system,[2,3] and bones were segmented from the reconstruction. The accuracy of NeRF-derived segmentations was evaluated by comparison to gold-standard CT segmentation. The number of input DRRs was varied to study how this parameter influences reconstructions. Volume reconstructions were readily obtained using the NeRF scene reconstruction system. RMS errors of the NeRF-derived segmentations ranged from 1.23 mm when using 36 input DRR images to 1.98 mm when using only 8 input DRR images. Based on this performance, we conclude that CT-free NeRF volume reconstruction from intra-operative fluoroscopy holds great potential for use in surgical navigation applications involving bony procedures.
{"title":"DESIGN AND EVALUATION OF A SYSTEM FOR CT-FREE VOLUME RECONSTRUCTION FROM INTRA-OPERATIVE FLUOROSCOPY FOR NAVIGATION IN ORTHOPEDIC SURGERY","authors":"Marcus Tatum, G. Thomas, D. Anderson","doi":"10.1115/dmd2023-9640","DOIUrl":"https://doi.org/10.1115/dmd2023-9640","url":null,"abstract":"\u0000 A novel biomechanical guidance system (BGS) for markerless intra-operative bone tracking that seamlessly integrates into the surgical setting was recently developed [1]. It utilizes 3D models from pre-operative CT, via 3D-to-2D registration methods, to update object poses based on 2D fluoroscopic images. However, on occasion pre-operative CT images may be unavailable. We developed a CT-free method to enable BGS use that leverages neural radiance fields (NeRF) to generate a continuous volumetric scene [2,3] from intra-operative fluoroscopy. For proof of concept, digitally reconstructed radiographs (DRRs) were created from pelvic CT data as a stand-in for intra-operative fluoroscopy. DRRs and virtual C-arm positions were fed into an existing NeRF scene reconstruction system,[2,3] and bones were segmented from the reconstruction. The accuracy of NeRF-derived segmentations was evaluated by comparison to gold-standard CT segmentation. The number of input DRRs was varied to study how this parameter influences reconstructions. Volume reconstructions were readily obtained using the NeRF scene reconstruction system. RMS errors of the NeRF-derived segmentations ranged from 1.23 mm when using 36 input DRR images to 1.98 mm when using only 8 input DRR images. Based on this performance, we conclude that CT-free NeRF volume reconstruction from intra-operative fluoroscopy holds great potential for use in surgical navigation applications involving bony procedures.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120931915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transcatheter aortic valve replacement (TAVR) has become a popular treatment option for severe aortic stenosis (AS) patients who present a high risk for mortality should they receive a surgical aortic valve replacement (SAVR). Coronary artery occlusion (CAO) following the implantation of the device is a potential complication with a high mortality rate, as CAO causes a deterioration of coronary perfusion, followed by cardiogenic shock and electrical instability. Due to this dangerous potential complication, bailout percutaneous coronary intervention (PCI) techniques, like the snorkel and chimney techniques, have been developed as an effective strategy for ensuring coronary perfusion is maintained following a TAVR procedure. Both snorkel and chimney techniques have been implemented in a reanimated swine and human heart respectively utilizing Visible Heart® methodologies. The procedures have been recorded utilizing endoscopic cameras, echocardiography, optical coherence tomography, and fluoroscopy. Post-procedural micro-computed tomography (micro-CT) was conducted to provide post-implantation imaging with approximately 60-micron resolution. The reconstructions are then segmented and used to create 3D renderings of these complex procedures. These methodologies are repeatable and can be used in a variety of conditions to be used in subsequent educational uses.
{"title":"BAILOUT POST-TAVR PCI TECHNIQUES IN REANIMATED SWINE AND HUMAN HEARTS: PROCEDURAL IMAGING AND POST-PROCEDURAL MODELING TECHNIQUES","authors":"Michael A. Bielecki, A. DeVos, P. Iaizzo","doi":"10.1115/dmd2023-2988","DOIUrl":"https://doi.org/10.1115/dmd2023-2988","url":null,"abstract":"\u0000 Transcatheter aortic valve replacement (TAVR) has become a popular treatment option for severe aortic stenosis (AS) patients who present a high risk for mortality should they receive a surgical aortic valve replacement (SAVR). Coronary artery occlusion (CAO) following the implantation of the device is a potential complication with a high mortality rate, as CAO causes a deterioration of coronary perfusion, followed by cardiogenic shock and electrical instability. Due to this dangerous potential complication, bailout percutaneous coronary intervention (PCI) techniques, like the snorkel and chimney techniques, have been developed as an effective strategy for ensuring coronary perfusion is maintained following a TAVR procedure. Both snorkel and chimney techniques have been implemented in a reanimated swine and human heart respectively utilizing Visible Heart® methodologies. The procedures have been recorded utilizing endoscopic cameras, echocardiography, optical coherence tomography, and fluoroscopy. Post-procedural micro-computed tomography (micro-CT) was conducted to provide post-implantation imaging with approximately 60-micron resolution. The reconstructions are then segmented and used to create 3D renderings of these complex procedures. These methodologies are repeatable and can be used in a variety of conditions to be used in subsequent educational uses.","PeriodicalId":325836,"journal":{"name":"2023 Design of Medical Devices Conference","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134021084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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