164 results on '"Device migration"'
Search Results
2. Stent-induced new entry and device migration associated with hemodynamic stress after thoracic endovascular aortic repair for type B chronic aortic dissection using computational fluid dynamics analysis: a case report
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Hosaka, Itaru, Uzuka, Takeshi, Umeta, Riko, and Sasaki, Akihiko
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- 2024
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3. Migration of the left atrial appendage closure device to the aorta
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González-Suárez, Susana, Barbosa, José Carlos Sureda, Siliato Robles, María Sol, and Paguay Fernández, Martha Magaly
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- 2024
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4. Late Migration of a Transcatheter Heart Valve
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Zaid Alirhayim, MD, Dean Kereiakes, MD, and Santiago Garcia, MD
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aortic stenosis ,device migration ,TAVR ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Migration or embolization of transcatheter aortic valve replacement (TAVR) prosthesis is an uncommon (usually acute) complication. Associated risk factors include malpositioning, pacing miscapture, undersizing, postdilation, and bicuspid anatomy. Delayed migration is exceedingly rare with little experience reported. The presentation can be catastrophic, requiring emergency surgery. Herein, we present a case of late TAVR migration managed with repeat transfemoral TAVR.
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- 2024
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5. Large and Giant Aneurysms
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Ren, Zeguang and Ren, Zeguang
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- 2022
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6. CORDX MASTERCLASS 2022.
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CARDIOLOGY , *CARDIOVASCULAR surgery , *CONFERENCES & conventions , *MEDICAL schools , *MEDICAL education - Published
- 2022
7. Coronary sinus reducer transfemoral extraction after intraprocedural device migration: A case report
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Matjaz Bunc, Miha Sustersic, Crt Langel, Dimitrij Kuhelj, and Shmuel Banai
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coronary sinus ,device migration ,reducer ,refractory angina ,snare ,transfemoral extraction ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract The coronary sinus reducer migration during implantation procedure is a rare complication with no standard bailout strategy. Transfemoral extraction of the reducer can be a safe and successful method, as demonstrated by this case report.
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- 2021
- Full Text
- View/download PDF
8. Infection and migration incidence of cardiac implantable electrical devices in Japan: Web‐based survey results
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Hiroshi Nakajima and Nobuhiro Nishii
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CIEDs ,device migration ,infection ,survey ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Web‐based survey was conducted for experiences of cardiac implantable electrical device (CIED) infection and migration in Japan. A total of 155 cardiologists’ answer was collected in January, 2018. CIED includes pacemaker (PM), implantable cardioverter defibrillator (ICD), cardiac resynchronization therapy pacemaker (CRT‐P), and cardiac resynchronization therapy ICD (CRT‐D) and total of 10,499 CIEDs’ experiences of within previous twelve months were reported. CIED includes pacemaker (PM), implantable cardioverter defibrillator (ICD), cardiac resynchronization therapy pacemaker (CRT‐P), and cardiac resynchronization therapy ICD (CRT‐D.). The infection rate of PM, ICD, CRT‐P, and CRT‐D was 0.79%, 0.81%, 0.45%, and 2.0%, respectively, and the device migration rate was 0.68%, 0.64%, 0.45%, and 0.93%, respectively. The overall infection rate was 0.85% and migration rate was 0.68%.
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- 2020
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9. Consensus Guidelines for the Prevention and Management of Periprocedural Complications of Transcatheter Patent Ductus Arteriosus Closure with the Amplatzer Piccolo Occluder in Extremely Low Birth Weight Infants.
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Sathanandam, Shyam, Gutfinger, Dan, Morray, Brian, Berman, Darren, Gillespie, Matthew, Forbes, Thomas, Johnson, Jason N., Garg, Ruchira, Malekzadeh-Milani, Sophie, Fraisse, Alain, Baspinar, Osman, and Zahn, Evan M.
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VERY low birth weight , *PATENT ductus arteriosus , *WEIGHT in infancy , *PREMATURE infants , *PHYSICIANS , *HEART valve prosthesis implantation - Abstract
Transcatheter closure of patent ductus arteriosus (PDA) in premature infants is a feasible, safe, and an effective alternative to surgical ligation and may be performed with an implant success rate of 97%. Major procedural complications related to transcatheter PDA closure in extremely low birth weight (ELBW) infants are relatively infrequent (< 3%) ,but may be associated with a fatality if not optimally managed. Operators performing transcatheter PDA closures should be knowledgeable about these potential complications and management options. Prompt recognition and treatment are often necessary to avoid serious consequences. With strict guidelines on operator training, proctoring requirements, and technical refinements, transcatheter PDA closure in ELBW infants can be performed safely with low complication rates. This article summarizes the consensus guidelines put forward by a panel of physicians for the prevention and management of periprocedural complications of transcatheter PDA closure with the Amplatzer Piccolo Occluder in ELBW infants. [ABSTRACT FROM AUTHOR]
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- 2021
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10. Anesthetic Management of Intracardiac Migration of Medical Devices.
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Holloway J, Lee M, Stephens B, Byun WY, Saklayen S, Anam K, and Awad H
- Abstract
The use of endovascular, percutaneous interventions to treat cardiac, arterial, and venous pathologies is becoming increasingly common in medical practice. While endovascular device placement typically carries a low risk, device migration remains a persistent problem with these procedures for which anesthesia providers must have a high index of suspicion. Anesthesia providers should be aware of the wide range of indications for such devices, potential migration locations, and hemodynamic consequences of both the inciting pathology and device migration so they can safely care for patients in these settings. This article aims to discuss a case series of five different device migration events, review the literature surrounding the migration of each device, and propose unique anesthetic considerations as well as a systematic approach by which to approach these complications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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11. Successful WEBectomy during embolization of temporal arteriovenous malformation-associated flow-related basilar aneurysms
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Cyril Dargazanli, Vincent Costalat, Federico Cagnazzo, Mohamed M Abdelrady, and Imad Derraz
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medicine.medical_specialty ,Solitaire Cryptographic Algorithm ,business.industry ,medicine.medical_treatment ,Endovascular Procedures ,Arteriovenous malformation ,Intracranial Aneurysm ,General Medicine ,Case presentation ,medicine.disease ,Embolization, Therapeutic ,Arteriovenous Malformations ,Treatment Outcome ,medicine ,Device migration ,Humans ,Female ,Radiology ,Embolization ,Endovascular treatment ,Complication ,business ,Stent retriever ,Aged ,Retrospective Studies - Abstract
Objective Intra-procedural WEB device migration is a scarcely reported complication that necessitates prompt intervention. Case Presentation Endovascular treatment of two broad necked flow-related aneurysms was planned aided by WEB-SL (Woven EndoBridge-single layer) devices in a 71-year-old female with known left temporal arteriovenous malformation. Inadvertent distal migration occurred while performing a control angiogram with an automated iodine injector. Immediate retrieval was successfully performed using a Solitaire stent-retriever. Conclusion To our knowledge, we report for the first time the successful retrieval of a distally migrated WEB using a stent-retriever device.
- Published
- 2023
12. Foreign Body Removal
- Author
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Genere, Juan Reyes, Siddiqui, Uzma D., and Adler, Douglas G., editor
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- 2017
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13. Coronary sinus reducer transfemoral extraction after intraprocedural device migration: A case report.
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Bunc, Matjaz, Sustersic, Miha, Langel, Crt, Kuhelj, Dimitrij, and Banai, Shmuel
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ANGINA pectoris - Abstract
The coronary sinus reducer migration during implantation procedure is a rare complication with no standard bailout strategy. Transfemoral extraction of the reducer can be a safe and successful method, as demonstrated by this case report. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
14. Surgical outcomes of simultaneous cochlear implantation with subtotal petrosectomy.
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Lee, Seulgi, Lee, Jong Bin, Chung, Jee-Hye, Park, Ki-Wan, and Choi, Jin Woong
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MASTOIDECTOMY , *EAR canal , *TEMPORAL bone , *COCHLEAR implants , *HEARING disorders , *REOPERATION - Abstract
Objective: To evaluate the surgical outcomes of simultaneous cochlear implantation (CI) with subtotal petrosectomy (SP).Methods: Medical records of thirty-one patients (31 ears) who underwent simultaneous CI with SP in two tertiary referral centers for management of profound hearing loss secondary to chronic suppurative otitis media, cholesteatoma, previous open cavity, temporal bone fracture, and temporal bone irradiation were retrospectively analyzed. Pre and postoperative speech performances and related complications requiring surgical correction were evaluated.Results: Significant improvement in postoperative speech performance was observed in all 31 patients compared to preoperative result. Of the 31 patients, complications occurred in three patients (9.6%). One patient exhibited the breakdown of blind sac closure of the external auditory canal and two others exhibited the migration of the receiver-stimulator cochlear implant. The migrations occurred despite tie-down fixation of the device to the skull. The migrated devices were repositioned using revision surgery.Conclusions: Simultaneous CI with SP is an effective and safe surgical method with relatively low complication incidence. However, particular attention should be paid to prevent certain complications. The receiver-stimulator may be predisposed to migrate to abnormal position because it can be placed with lack of tight subperiosteal support at a more superior or posterior location of the skull where the skull curvature changes abruptly than can conventional CI using limited mastoidectomy and posterior tympanotomy approach. [ABSTRACT FROM AUTHOR]- Published
- 2020
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15. Infection and migration incidence of cardiac implantable electrical devices in Japan: Web‐based survey results.
- Author
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Nakajima, Hiroshi and Nishii, Nobuhiro
- Abstract
Web‐based survey was conducted for experiences of cardiac implantable electrical device (CIED) infection and migration in Japan. A total of 155 cardiologists' answer was collected in January, 2018. CIED includes pacemaker (PM), implantable cardioverter defibrillator (ICD), cardiac resynchronization therapy pacemaker (CRT‐P), and cardiac resynchronization therapy ICD (CRT‐D) and total of 10,499 CIEDs' experiences of within previous twelve months were reported. CIED includes pacemaker (PM), implantable cardioverter defibrillator (ICD), cardiac resynchronization therapy pacemaker (CRT‐P), and cardiac resynchronization therapy ICD (CRT‐D.). The infection rate of PM, ICD, CRT‐P, and CRT‐D was 0.79%, 0.81%, 0.45%, and 2.0%, respectively, and the device migration rate was 0.68%, 0.64%, 0.45%, and 0.93%, respectively. The overall infection rate was 0.85% and migration rate was 0.68%. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
16. RTSM: Response time optimisation during switch migration in software‐defined wide area network.
- Author
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Sahoo, Kshira Sagar, Tiwary, Mayank, Sahoo, Bibhudatta, Mishra, Brojo Kishore, RamaSubbaReddy, Somula, and Luhach, Ashish Kr.
- Abstract
The distributed control plane is the alternate solution to reliability and scalability like potential issues in the software‐defined wide area network (SDWAN), but the static mapping between controller and switches might cause an uneven load distribution among controllers. Migration of switches from one controller to another under‐loaded controller is a solution to handle the peak traffic. However, the switch migration process is a complex process that may affect the end‐user quality of service (QoS), as a result, the response time of the control messages are also affected. To address this issue, the authors present RTSM, a novel strategy, that optimises the response time of the control messages during switch migration. Further, an SDWAN architecture was proposed, in which the introduction of the layer‐2 controller reduces the dependency on WAN communication of the forwarding devices. The Karush–Kuhn–Tucker conditions have been applied for target controller selection, which ensures improved response time. A switch selection method was also introduced, which minimally affects the end‐user QoS during device migration in SDWAN scenario. To evaluate the performance of the RTSM, Mininet simulator with the Floodlight controller has been used, and the result shows that the proposed algorithm outperforms the other existing works during load balancing. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
17. AMPLATZER™ Duct Occluder II AS embolization to left pulmonary artery related to thrombolytic therapy: Surgical rescue without cardiopulmonary bypass.
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Éden Santos, P., Correia-Costa, A., Pissarra, Diana, Moreira, J., Carlos Silva, J., Rodrigues Sousa, A., and João Baptista, M.
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CARDIOPULMONARY bypass , *PULMONARY artery , *THROMBOLYTIC therapy , *PATENT ductus arteriosus , *DUCTUS arteriosus , *DOPPLER ultrasonography - Abstract
Abstract We report a case of a 7-month-old girl (5.2 kg), submitted to transcatheter closure of patent ductus arteriosus with AMPLATZER™ Duct Occluder II AS device. Six hours after the procedure the patient developed right inferior limb coldness with absent pedal and tibial pulse. Unfractionated heparin was immediately started. Doppler ultrasound confirmed the absence of flow in the right femoral artery, and thrombolysis with Alteplase infusion began, with positive results in the inferior limb ischemia. The next morning echocardiogram showed a newly-patent ductus arteriosus. CT-angiography revealed an embolized device into the inferior lobar left pulmonary artery. Thus, to prevent late effects of a foreign object in the pulmonary artery, the patient was referred to surgery for device retrieval. Surgery outcome was positive without cardiopulmonary bypass. There was no sign of thrombus formation in the device mesh. Recovery was uneventful, and the patient was discharged five days after the operation. To our knowledge, this is the first patient in whom surgery rescue of this specific device was successfully performed without the need of cardiopulmonary bypass. Highlights • The ADO™ II AS is a PDA device occluder which allows a safe and efficient implantation in neonates and small infants. • Reports of this device's embolization are rare. • In this case, the embolization may be related to thrombolytic therapy (unusual). • Most of the surgical attempts to remove these devices were conducted with the aid of cardiopulmonary bypass. • In this case, surgery outcome was positive without cardiopulmonary bypass avoiding the endeavour and risks related to it. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
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18. Distensibility of the ductus arteriosus in neonates and young infants undergoing transcatheter closure
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Hiroki Ezaki, Hirohito Doi, Takashi Furuta, Mamie Watanabe, Kota Nagasawa, Jun Muneuchi, Yuichiro Sugitani, and Masaru Kobayashi
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Cardiac Catheterization ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Younger age ,Septal Occluder Device ,business.industry ,Infant, Newborn ,Infant ,Ductus Arteriosus ,Vascular surgery ,Young infants ,Cardiac surgery ,Treatment Outcome ,medicine.anatomical_structure ,Internal medicine ,Ductus arteriosus ,Cardiology ,Device migration ,Humans ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Ductus Arteriosus, Patent ,Retrospective Studies - Abstract
Device migration is one of serious complications in neonates and infants undergoing transcatheter closure of the patent ductus arteriosus (PDA). We hypothesize that neonates and young infants possess the distensibility of the ductus, which may be related to device migration. We retrospectively reviewed angiographic findings in 41 neonates and infants who underwent transcatheter closure of PDA. We measured diameters of the ductus at the pulmonary (PA) side, the center, and the aortic (AO) side before PDA closure, and the device center diameter after device closure. The distensibility index was defined as the ratio of the device center diameter after device deployment to the diameter at the center of the ductus before PDA closure. Age and weight at the procedure were 168 (117–260) days and 5.3 (4.3–6.9) kg, respectively. Thirty-seven subjects accomplished the successful device closure, and four subjects were declined because of the device instability or migration. Implanted devices included Amplatzer Duct Occluders in 33 subjects and Amplatzer Vascular Plug-2 in 8 subjects. The PDA diameters at PA side, at the center, AO side, and the device center diameter were 3.2 (2.2–4.3) mm, 4.7 (3.6–5.7) mm, 7.7 (6.3–9.4) mm, and 5.8 (4.2–6.9) mm, respectively. The PDA diameter before closure was not correlated age and weight. The distensibility index was 1.28 (1.06–1.64), which was significantly correlated to age (r = − 0.49, P = 0.001) and weight (r = − 0.53, P
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- 2021
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19. Twiddler’s syndrome
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Mohammad Alasti and Logan Bittinger
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Device migration ,Twiddler’s syndrome ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
We presented an old patient with CRT-D who was admitted because of lead dislodgement due to Twiddler's syndrome.
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- 2018
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20. Coronary sinus reducer transfemoral extraction after intraprocedural device migration: A case report
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Dimitrij Kuhelj, Miha Sustersic, Shmuel Banai, Matjaz Bunc, and Crt Langel
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Medicine (General) ,medicine.medical_specialty ,snare ,Case Report ,Case Reports ,reducer ,030204 cardiovascular system & hematology ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Device migration ,Medicine ,Implantation procedure ,Coronary sinus ,device migration ,Reducer ,coronary sinus ,refractory angina ,business.industry ,Extraction (chemistry) ,food and beverages ,General Medicine ,Surgery ,030220 oncology & carcinogenesis ,business ,Complication ,Refractory angina ,transfemoral extraction - Abstract
The coronary sinus reducer migration during implantation procedure is a rare complication with no standard bailout strategy. Transfemoral extraction of the reducer can be a safe and successful method, as demonstrated by this case report.
- Published
- 2020
21. Un-LINQed: Spontaneous extrusion of newer generation implantable loop recorders
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Thomas J. Blount, Sunita J. Ferns, Anil K. Gehi, and Joseph Zakhar
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lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Heart disease ,Pediatric electrophysiology ,030204 cardiovascular system & hematology ,Arrhythmia monitoring ,Tertiary care ,03 medical and health sciences ,0302 clinical medicine ,Implantable loop recorder (ILR) ,Physiology (medical) ,Implantable loop recorder ,medicine ,Device migration ,030212 general & internal medicine ,High rate ,business.industry ,medicine.disease ,Surgery ,Device extrusion ,Ecg monitoring ,medicine.anatomical_structure ,lcsh:RC666-701 ,Insertable cardiac monitor (ICM) ,Original Article ,Implant ,Cardiology and Cardiovascular Medicine ,business ,Subcutaneous tissue - Abstract
Background Insertable cardiac monitors (ICMs) are often used for long-term monitoring of cardiac rhythm. The Medtronic’s LINQ Reveal ™ is a new generation wireless, automated, and patient responsive subcutaneous ECG monitoring device. Despite several advantages to its small size we have noted an unusually high incidence of extrusion at our center. Methods & Results: We conducted a retrospective case analysis to review Reveal LINQs implanted at our center. All devices were inserted using the provided insertion tools. Patients with extruded devices were identified and details regarding the site and technique of insertion, incision closure, use of peri-operative antibiotics, and follow-up details were collected. 81 patients underwent 85 Reveal LINQ implants at a tertiary care University Hospital referral center. The most common reason for implant was suspected arrhythmia with or without structural heart disease or unexplained syncope. There were 4 spontaneous extrusions occurring within 7–24 days after insertion with an incidence rate of 4.7%. One extruded device was anchored to subcutaneous tissue, and no pocket/device infections or hematomas were noted. Conclusions Device migration and erosion through skin are important potential adverse events for the Reveal LINQ implantable loop recorder. This study reports an unexpectedly high rate of extrusion without infection. The authors suggest that the depth of the incision is the main factor impacting extrusions. Larger studies are recommended, however, and a proposed measure to avoid spontaneous extrusion is the design of a longer manufacturer’s blade in order to increase the depth of the incision and insertion.
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- 2020
- Full Text
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22. Transseptal occluder migration after transcatheter atrial septal aneurysm and double secondary septal defect correction: A case report
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Anton A. Khilchuk, Dmitriy A. Zverev, Valentin V. Guryev, and Sergey G. Shcherbak
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lcsh:Medical physics. Medical radiology. Nuclear medicine ,medicine.medical_specialty ,Transcatheter occlusion ,medicine.medical_treatment ,lcsh:R895-920 ,Arteriotomy ,Femoral artery ,Balloon ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Defect closure ,0302 clinical medicine ,medicine.artery ,medicine ,Device migration ,Atrial septal aneurysm ,Fluoroscopy ,Radiology, Nuclear Medicine and imaging ,Migration ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Atrial septal rupture ,Occluder ,Atrial septal defect ,Radiology ,business ,Cardiac ,030217 neurology & neurosurgery - Abstract
We present a case of secondary atrial septal defect transcatheter correction attempt in a 72 years old male, complicated by the device migration. The occluder was captured, pulled down to the common femoral artery and retrieved through the arteriotomy site. Second attempt was successfully performed using combination of transesophageal echo (TEE) and sizing balloon to accurately measure the defect diameter. This case underscores the importance of TEE ultrasound, sizing balloon, and contrast fluoroscopy combination to achieve accurate device sizing. Our calculation approach significantly increased the success rate of the septal defect closure procedure and potentially reduced the risk of immediate and mid-term complications. Combination of measuring methods should be used in order to accurately assess the device diameter.
- Published
- 2020
23. Midterm Degeneration of Transcatheter Heart Valve Device following Valve-in-Valve Transcatheter Aortic Valve Replacement Requiring Repeat Transcatheter Aortic Valve Replacement
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Cesare Quarto, Simon J. Davies, and Alison Duncan
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medicine.medical_specialty ,Transcatheter aortic ,business.industry ,medicine.medical_treatment ,TAVR-in-TAVR ,Interventional Image Guidance ,Valve-in-Valve TAVI ,General Medicine ,Degeneration (medical) ,Valve in valve ,medicine.anatomical_structure ,Valve replacement ,Internal medicine ,medicine ,Device migration ,Cardiology ,Heart valve ,business ,ComputingMethodologies_COMPUTERGRAPHICS - Abstract
Graphical abstract, Highlights • ViV-TAVR is an alternative to redo-SAVR in patients with a degenerate surgical bioprosthesis. • Optimal TAVR device positioning is crucial in determining procedural durability. • TAVR-in-TAVR can be performed to treat a degenerated ViV-TAVR device. • Coronary obstruction, limited coronary access, and device thrombosis may occur.
- Published
- 2020
- Full Text
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24. RTSM: Response time optimisation during switch migration in software‐defined wide area network
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Kshira Sagar Sahoo, Bibhudatta Sahoo, Somula Ramasubbareddy, Ashish Kr. Luhach, Brojo Kishore Mishra, and Mayank Tiwary
- Subjects
business.industry ,Computer science ,Quality of service ,Distributed computing ,010401 analytical chemistry ,Response time ,Floodlight ,020206 networking & telecommunications ,02 engineering and technology ,Load balancing (computing) ,01 natural sciences ,Industrial and Manufacturing Engineering ,0104 chemical sciences ,Software ,Wide area network ,Scalability ,0202 electrical engineering, electronic engineering, information engineering ,Device migration ,business - Abstract
The distributed control plane is the alternate solution to reliability and scalability like potential issues in the software-defined wide area network (SDWAN), but the static mapping between controller and switches might cause an uneven load distribution among controllers. Migration of switches from one controller to another under-loaded controller is a solution to handle the peak traffic. However, the switch migration process is a complex process that may affect the end-user quality of service (QoS), as a result, the response time of the control messages are also affected. To address this issue, the authors present RTSM, a novel strategy, that optimises the response time of the control messages during switch migration. Further, an SDWAN architecture was proposed, in which the introduction of the layer-2 controller reduces the dependency on WAN communication of the forwarding devices. The Karush–Kuhn–Tucker conditions have been applied for target controller selection, which ensures improved response time. A switch selection method was also introduced, which minimally affects the end-user QoS during device migration in SDWAN scenario. To evaluate the performance of the RTSM, Mininet simulator with the Floodlight controller has been used, and the result shows that the proposed algorithm outperforms the other existing works during load balancing.
- Published
- 2020
- Full Text
- View/download PDF
25. Revision of subcutaneous implantable cardioverter defibrillator to intermuscular pocket to prevent inappropriate shocks
- Author
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Jeko M. Madjarov, Svetozar Madzharov, John M. Fedor, Stefanie Chappuis, and Filip Abedinov
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medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Medicine ,Case Report ,Case Reports ,030204 cardiovascular system & hematology ,S‐ICD ,Defibrillation threshold ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,intermuscular ,medicine ,Device migration ,sensing vector ,lcsh:R5-920 ,Inappropriate shock ,business.industry ,lcsh:R ,General Medicine ,Implantable cardioverter-defibrillator ,inappropriate shock ,030220 oncology & carcinogenesis ,Cardiology ,Implant ,lcsh:Medicine (General) ,business - Abstract
Sensing and defibrillation threshold for a S‐ICD are impacted by positioning at implant or revision. The intermuscular pocket prevents device migration and provides appropriate, stable sensing vectors.
- Published
- 2020
- Full Text
- View/download PDF
26. Reliability of CIR-S using the subperiosteal pocket technique under 2 years of age
- Author
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Ünal Gökalp Işik, Erdem Atalay Cetinkaya, Nuray Ensari, Dogukan Aydenizoz, Ömer Tarık Selçuk, Hülya Eyigör, Gamze Ozturk Yılmaz, and Muhammet Yildiz
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Soft tissue ,Infant ,Reproducibility of Results ,Cochlear Implantation ,Surgery ,Speech and Hearing ,Skull ,medicine.anatomical_structure ,Cochlear Implants ,Postoperative Complications ,Otorhinolaryngology ,Small incision ,Radiological weapon ,Cochlear implant ,Child, Preschool ,medicine ,Device migration ,Humans ,Postoperative Period ,business ,Cochlear implantation ,Fixation (histology) - Abstract
OBJECTIVE It is aimed in this study to investigate the reliability of the cochlear implant receiver-stimulator (CIR-S) placement using unfixed subperiosteal tight pocket technique and the postoperative soft tissue changes that occur around the CIR-S, in toddlers under 2 years of age. METHODS Nonsyndromic toddlers with normal radiological findings and who were planned to have cochlear implantation were included in the study. Preoperative and postoperative complications, device migration, and postoperative soft tissue changes occurred around the CIR were analyzed using objective methods. RESULTS Twenty-six toddlers aged between 12 and 24 months who met the study criteria were followed up for a mean follow-up duration of 18 months. No intraoperative and postoperative surgical complications and device migration were observed in any of the cases included in the study. CONCLUSION It was concluded as a result of this study that cochlear implant receiver-stimulator placement using the subperiosteal pocket technique is reliable in toddlers under 2 years of age, provided that the small incision tight subperiostal pocket technique is performed meticulously without fixation and well drilling, and that device-protective changes occur in the tissues around the CIR-S over time with the use of the device and as the child skull develops.
- Published
- 2021
27. Antegrade and retrograde embolisation of valves ensuing Transcatheter aortic valve implantation (TAVI)
- Author
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Bhaskar Ranganathan, Manoras Mathew Chengalath, Jeevesh John Thomas, Grace Maria George, and Jose Chacko Periappuram
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medicine.medical_specialty ,Transcatheter aortic ,business.industry ,030204 cardiovascular system & hematology ,medicine.disease ,Surgery ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,Ventricle ,medicine.artery ,Ascending aorta ,medicine ,Device migration ,business ,Complication - Abstract
There has been significant rise in Transcatheter aortic valve implantations (TAVI) worldwide. Displacement of the TAVI device is a potential life threatening complication. We present a case of 79 years old with severe aortic stenosis who underwent TAVI. When the valve got displaced into the ascending aorta, a second valve was deployed. The second valve gets displaced into the left ventricle. Failure of interventional efforts forced us to surgically explore to find extensive bruising and a dissected ascending aorta. Though the rate of device migration is quite low, a good understanding of the implicating factors will help the operator to avoid such a disaster.
- Published
- 2019
- Full Text
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28. Efficacy and Safety of AMPLATZER Vascular Plug Type IV for Embolization of Pulmonary Arteriovenous Malformations
- Author
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Jongmin Lee, Ung Rae Kang, Seung Ick Cha, Young Hwan Kim, Chang Ho Kim, Jaehee Lee, Jung Guen Cha, and Sang Yub Lee
- Subjects
Adult ,Male ,Tachycardia ,Pulmonary Circulation ,Time Factors ,medicine.medical_treatment ,Technical success ,Vascular plug ,Pulmonary Artery ,030218 nuclear medicine & medical imaging ,Arteriovenous Malformations ,03 medical and health sciences ,0302 clinical medicine ,Occlusion ,medicine ,Device migration ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Equipment Design ,Middle Aged ,Embolization, Therapeutic ,Treatment Outcome ,Pulmonary Veins ,030220 oncology & carcinogenesis ,Angiography ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business - Abstract
Purpose To assess the efficacy and safety of the AMPLATZER Vascular Plug type IV for pulmonary arteriovenous malformation (PAVM) treatment. Materials and Methods Between June 2013 and January 2018, 13 patients with 26 PAVMs were treated with the type IV AVP. Patients without follow-up computed tomography (CT) were excluded. Technical success was defined as flow occlusion on angiography. Plug-to-sac distance was measured on angiographic images. Feeding artery and venous sac diameter changes were measured on preprocedural and follow-up CT. Successful embolization was defined as > 70% sac size regression. Procedure time, device migration, and complications were evaluated. Results Nine female patients (mean age, 49 y; range, 40–71 y) with 19 PAVMs were enrolled. Four patients with 7 PAVMs were lost to follow-up. Nineteen PAVMs were treated in 11 sessions, and the mean procedure time was 29 min. The technical success rate was 100%. Mean feeding artery diameter was 3.1 mm ± 0.7 (range, 2.1–4.9 mm). Mean plug-to-sac distance was 5.4 mm ± 4.9 (range, 0–13.3 mm). The mean CT follow-up period was 14 months ± 7 (range, 6–30 mo). Sixteen of 19 PAVMs (84%) were successfully embolized. Minor complications (tachycardia and chest discomfort) arose in 2 of 11 sessions. No device migrations or major complications occurred. Conclusions The type IV AVP showed an 84% treatment success rate based on 70% sac size regression criteria in small PAVMs. There were no device migrations or major complications.
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- 2019
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29. Safety of EndoAnchors in real-world use: A report from the Manufacturer and User Facility Device Experience database
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Kamal Gupta, Reza Masoomi, Zvonimir Krajcer, Ethan Hacker, Emily Lancaster, and Alexander Robinson
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medicine.medical_specialty ,Time Factors ,Databases, Factual ,medicine.medical_treatment ,endoleak ,030204 cardiovascular system & hematology ,Risk Assessment ,Endovascular aneurysm repair ,Blood Vessel Prosthesis Implantation ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Cognitive Complications ,Risk Factors ,medicine.artery ,Device migration ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,User Facility ,030212 general & internal medicine ,business.industry ,Endovascular Procedures ,Abdominal aorta ,Original Articles ,General Medicine ,EndoAnchor ,Manufacturer and User Facility Device Experience ,Blood Vessel Prosthesis ,Surgery ,Treatment Outcome ,Stents ,Cardiology and Cardiovascular Medicine ,business ,Proximal neck ,Aortic Aneurysm, Abdominal - Abstract
Objectives A hostile proximal neck anatomy is the most common cause of abdominal aorta endovascular aneurysm repair failure leading to a higher risk of device migration, proximal type I endoleak, and subsequent open surgical repair. Endostapling is a technique to attain better fixation of the endograft to the aortic wall, and the only available device in the USA is Aptus Heli-FX EndoAnchor system (Medtronic Vascular, Santa Rosa, CA, USA). Preliminary data have shown efficacy and safety of its use, and the aim of this study is to assess device-related adverse events in real-world clinical use. Methods We quarried data from the publicly available Manufacturer and User Facility Device Experience database to identify Aptus Heli-FX EndoAnchor system-related adverse reports in endovascular aneurysm repair since FDA approval till August 31, 2017. An estimate of total devices implanted in the United States was quoted around 7,000 (Medtronic marketing internal data). Results Our query identified 229 separate reports, of which there were 85 adverse events (1.2% of the estimated EndoAnchor systems used). The most common adverse events were device dislodgement/fracture (65) and applicator malfunction (20). Conclusion In early post-FDA approval use in a real-world setting, the EndoAnchor system is associated with a low rate of adverse events. Device dislodgement and embolization remain the most common adverse events. With increasing use of these devices in more difficult anatomy, careful patient selection and careful attention to technique may help to reduce these events even further.
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- 2019
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30. Outcome of Nellix-EVAS: single center mid-term results
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P. Wigger, Arash Najafi, Christoph A. Binkert, and Gabriel Tobias Sheikh
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medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.diagnostic_test ,Endoleak ,business.industry ,Technical success ,Mid term results ,Interventional radiology ,Aortic repair ,Single Center ,Surgery ,lcsh:RC666-701 ,medicine ,Device migration ,Original Article ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Nellix ,Proximal neck ,EVAS ,Migration - Abstract
Background Endovascular aortic sealing (EVAS) using the Nellix system was a new approach to reduce the frequency of type II endoleaks after endovascular aortic repair. We analyzed the mid-term results, specifically looking at device migration, endoleaks and subsequent necessary secondary interventions. Results Ten patients underwent elective EVAS treatment during our study period. 7 patients were within the IFU while 3 patients had a proximal neck shorter than 10 mm. Technical success rate was 100% and there were no short-term vascular complications. One patient died from urosepsis 14 days after the procedure and was excluded from further analysis. A total of 6 out of 9 patients (67%) experienced device complications such as proximal graft kinking, limb separation or caudal migration. 5 also showed type Ia endoleak. Discussion While no complication occurred short-term (up to 12 months), the Nellix system showed a high percentage of limb separation, caudal graft migration, and type Ia endoleak on mid-term follow-up, likely due to insufficient proximal anchoring of the device. Possible salvage treatments are discussed.
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- 2019
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31. The Nellix endovascular aneurysm sealing system: current perspectives
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Shahin Hajibandeh, Shahab Hajibandeh, Xin Y Choo, and George A. Antoniou
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Technical success ,Biomedical Engineering ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,medicine.disease ,Endovascular aneurysm repair ,Asymptomatic ,Abdominal aortic aneurysm ,03 medical and health sciences ,Aortic aneurysm ,0302 clinical medicine ,Aneurysm ,Internal medicine ,medicine ,Device migration ,In patient ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Background The Nellix endovascular aneurysm sealing (EVAS) system is a novel approach for the treatment of abdominal aortic aneurysm (AAA). We aimed to evaluate the efficacy of EVAS in the management of patients with AAA. Materials and methods We searched PubMed/MEDLINE, CINAHL, and bibliographic reference lists to identify studies reporting clinical outcomes in patients with asymptomatic, non-ruptured AAA treated with EVAS with the Nellix device. We pooled dichotomous outcome data using random-effects models. Results We identified 14 single-arm observational studies, reporting a total of 1,510 patients. The pooled estimate of technical success was 99% (95% CI =98-100; heterogeneity: P=0.869, I2=0%). Adjunctive procedures were carried out in 39% (95% CI =19-63; heterogeneity: P
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- 2019
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32. A Stuck Amplatzer Septal Occluder.
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Bhasin, Dinkar, Ramakrishnan, Sivasubramaniam, Nanda, Saurabh, Pradeep, Ramakrishnan, and Choudhary, Shiv Kumar
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- *
ATRIAL septal defects , *CARDIAC catheterization , *TREATMENT effectiveness - Published
- 2021
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33. Mechanical properties and fluid permeability of gyroid and diamond lattice structures for intervertebral devices: functional requirements and comparative analysis
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Vladimir Brailovski, V. Sheremetyev, and Anatolie Timercan
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Materials science ,102 Porous / Nanoporous / Nanostructured materials ,106 Metallic materials ,02 engineering and technology ,010402 general chemistry ,01 natural sciences ,305 Plasma / Laser processing ,Device migration ,General Materials Science ,Diamond cubic ,Composite material ,Materials of engineering and construction. Mechanics of materials ,211 Scaffold / Tissue engineering / Drug delivery ,Functional requirement ,021001 nanoscience & nanotechnology ,10 Engineering and Structural material ,geometric analysis ,0104 chemical sciences ,fluid permeability ,Permeability (electromagnetism) ,mechanical testing ,TA401-492 ,Lattice structures ,Intervertebral fusion ,Engineering and Structural materials ,Current (fluid) ,0210 nano-technology ,additive manufacturing ,TP248.13-248.65 ,Gyroid ,Biotechnology ,Research Article - Abstract
Current intervertebral fusion devices present multiple complication risks such as a lack of fixation, device migration and subsidence. An emerging solution to these problems is the use of additively manufactured lattice structures that are mechanically compliant and permeable to fluids, thus promoting osseointegration and reducing complication risks. Strut-based diamond and sheet-based gyroid lattice configurations having a pore diameter of 750 µm and levels of porosity of 60, 70 and 80% are designed and manufactured from Ti-6Al-4V alloy using laser powder bed fusion. The resulting structures are CT–scanned, compression tested and subjected to fluid permeability evaluation. The stiffness of both structures (1.9–4.8 GPa) is comparable to that of bone, while their mechanical resistance (52–160 MPa) is greater than that of vertebrae (3–6 MPa), thus decreasing the risks of wither bone or implant failure. The fluid permeability (5–57 × 10−9 m2) and surface-to-volume ratios (~3) of both lattice structures are close to those of vertebrae. This study shows that both types of lattice structures can be produced to suit the application specifications within certain limits imposed by physical and equipment-related constraints, providing potential solutions for reducing the complication rate of spinal devices by offering a better fixation through osseointegration.
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- 2021
34. Estudio de plataformas MDM en arquitecturas distribuidas
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Antoranz García, Judit, Universitat Autònoma de Barcelona. Escola d'Enginyeria, and César Galobardes, Eduardo
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Migración de dispositivos ,Migració de dispositius ,Mobile Device Management (MDM) ,VMWare Workspace ONE ,Legacy ,Políticas de seguridad ,Transports Metropolitans de Barcelona (TMB) ,Organization Groups ,Barcelona Metropolitan Transport (TMB) ,Polítiques de seguretat ,Grups Organitzatius (OG) ,Security policies ,Device migration ,Enterprise - Abstract
La empresa TMB se encuentra en pleno proceso de adquisición de dispositivos móviles para el parque empresarial, conllevando esto un aumento considerable en la gestión y configuración de los mismos. Con el análisis y estudio de la plataforma utilizada, VMWare Workspace ONE, se pretende conseguir una mejora cualitativa en la gestión de los dispositivos móviles permitiendo una creación de usuarios y grupos con unas características específicas para cada uno, así como la creación e implementación de políticas de seguridad para cada uno de los grupos. Finalmente se pretende conseguir establecer un plan de migración eficaz y eficiente entre los modos de gestión Legacy y Entreprise para los dispositivos Android. Este plan de migración debe permitir migrar los dispositivos al modo Enterprise utilizando el modo Work Managed o el modo COPE. El proyecto resulta beneficioso para la empresa ya que le proporciona soluciones eficientes en la creación de usuarios, Smart Groups, implementación de perfiles de seguridad y migración de dispositivos. Esta eficiencia queda demostrada en la semiautomatización de las tareas y el aumento de la cantidad de dispositivos migrados en una sola operación de migración. The company TMB is in the process of acquiring Mobile devices for the business park, leading to a considerable increase in their management and configuration of devices. With the analysis and study of the platform used, VMWare Workspace ONE, aims to advise a qualitative improvement in the management of Mobile devices allowing the creation of users and groups with specific characteristics for each one, as well as the creation and implementation of security policies for each of the groups. Finally, the aim is to establis han optimal and eficient migration plan between Legacy and Enterprise management modes for Android devices. This migration plan should allow devices to be migrated to Enterprise mode using either Work Managed or Corporate Owned Personally Enabled (COPE) mode. The developed project is beneficial for the company as it provides efficient solutions in the creation of users, Smart Groups, implementation of security profiles and device migration. This efficiency is demonstrated in the semi-automation of tasks and the increase in the number of migrated devices in a single migration operation. L'empresa TMB es troba en ple procés d'adquisició de dispositius mòbils per al seu parc empresarial, comportant això un augment considerable en la gestió i configuració dels mateixos. Amb l'anàlisi i estudi de la plataforma utilitzada, VMWare Workspace ONE, es pretén aconseguir una millora qualitativa en la gestió de dispositius mòbils permetent una creació d'usuaris i grups amb unes característiques específiques per a cadascun, així com la creació i implementació de polítiques de seguretat per a cadascun dels grups. Finalment es pretén aconseguir establir un pla de migració eficaç i eficient entre els modes de gestió Legacy i Enterprise per a dispositius Android. Aquest pla de migració ha de permetre migrar els dispositius a mode Enterprise fent servir el mode Work Managed o el mode COPE. El projecte resulta beneficiós per a l'empresa ja que li proporciona solucions eficients en la creació d'usuaris, Smart Groups, implementació de perfils de seguretat i migració de dispositius. Aquesta eficiència queda demostrada en la semi automatització de tasques i l'augment de la quantitat de dispositius migrats en una sola operació de migració.
- Published
- 2021
35. Prosthetics: Erectile Implant, Testicular Implants
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Lee C. Zhao, Geolani W. Dy, Ian T Nolan, and Nabeel Shakir
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Penile prosthesis ,Neurovascular bundle ,Prosthesis ,Surgery ,Increased risk ,medicine ,Device migration ,Implant ,Phalloplasty ,business ,Fixation (histology) - Abstract
Erectile ability is a common goal for transgender men seeking phalloplasty, which necessitates prosthesis placement in most phalloplasty techniques. In the absence of preexisting corpora, implant placement is associated with increased risk of poor proximal fixation, device migration, distal erosion, and neurovascular compromise, infection, and malfunction. Modifications to conventional surgical technique, such as avoidance of critical structures, proximal prosthesis anchoring, and distal cushioning with vascular or synthetic grafts, are common techniques to address anatomic challenges.
- Published
- 2021
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36. Posterior Tympanotomy Versus Subtotal Petrosectomy: A Comparison of Complications in Cochlear Implantation
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Jong Bin Lee, Seulgi Lee, Jin Woong Choi, and Jee-Hye Chung
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Reoperation ,medicine.medical_specialty ,medicine.medical_treatment ,Device placement ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Device migration ,Medicine ,Humans ,Major complication ,030223 otorhinolaryngology ,Cochlear implantation ,Craniotomy ,Fixation (histology) ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Cochlear Implantation ,Middle Ear Ventilation ,Sensory Systems ,Surgery ,Cochlear Implants ,Otorhinolaryngology ,Neurology (clinical) ,business ,Complication ,030217 neurology & neurosurgery - Abstract
Objective To compare the postoperative complications between posterior tympanotomy cochlear implantation (PTCI) and subtotal petrosectomy cochlear implantation (SPCI). Study design A retrospective cohort study. Setting Two tertiary referral centers. Patients Two hundred ninety-eight patients who underwent PTCI and 33 who underwent SPCI. Interventions Cochlear implantation using either posterior tympanotomy or subtotal petrosectomy. Main outcome measures Postoperative complications between the two groups were compared after categorization into minor complications (requiring conservative management) and major complications (requiring surgical revision or hospitalization treatment). Results Dizziness was the most common complication in both groups. The major complication rate in the SPCI group was significantly higher than in the PTCI group (12.1% [4 of 33] versus 1.3% [4 of 298], p = 0.004), while the minor complication rate was similar between the two groups. Among the major complications, device migration was significantly more common when SPCI was performed (9.1% [3 of 33] versus 0.3% [1 of 298], p = 0.003). Conclusions Major complication rate of SPCI was higher than that of PTCI; particularly, device migration was more commonly observed after SPCI than PTCI. Therefore, special attention should be paid to device placement and fixation during SPCI.
- Published
- 2020
37. Proximal anchor fixation in magnetically controlled growing rods (MCGR): preliminary 2-year results of the impact of anchor location and density
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Peter Sturm, Jason B Anari, Blake C Meza, Suken A. Shah, Michael G. Vitale, and Scott J. Luhmann
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Male ,medicine.medical_specialty ,Time Factors ,Radiography ,Spinal deformity correction ,Scoliosis ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,medicine ,Device migration ,Humans ,Multicenter Studies as Topic ,Orthopedics and Sports Medicine ,Age of Onset ,Child ,Retrospective Studies ,Orthodontics ,030222 orthopedics ,business.industry ,medicine.disease ,Sagittal plane ,Internal Fixators ,Spine ,Patient Outcome Assessment ,medicine.anatomical_structure ,Spinal Fusion ,Coronal plane ,Orthopedic surgery ,Female ,business ,Complication ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Multicenter, retrospective cohort study. Analyze the impact of MCGR proximal anchor location and density on radiographic outcomes and complications. Magnetically controlled growing rods (MCGRs) reduce the need for repeat operations for lengthening when treating spinal deformity in children. The evidence behind choosing the location and density of proximal anchors comes from the traditional growing rod and rib-based distraction technique literature. Thus, there is much debate regarding the optimal quantity and location of proximal anchors. This study included early-onset scoliosis patients treated with MCGR with a minimum 2-year follow-up. Comparisons of 2-year correction in the coronal and sagittal planes, complication rates, and patient-reported outcomes were made based on proximal fixation type, proximal anchor density, and type of case (primary, conversion). This study included 155 MCGR patients. Spinal deformity correction at 2 years was significantly higher in spine-based than rib-based constructs, in terms of both the major (23.9° vs. 17.1°, p = 0.05) and minor curves (10.0° vs. 4.5°, p = 0.03). Greater proximal anchor density, regardless of location, was also associated with better major curve correction at 2 years (25.0° vs. 18.2°, p
- Published
- 2020
38. Intracolonic cardiac pacemaker: A case of device migration with colon perforation out of a subcutaneous epifascial pocket
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Rémy Liechti, Sonja Bertschy, Ian Russi, Vanessa Weberndoerfer, Richard Kobza, and Elza Memeti
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medicine.medical_specialty ,Heart block ,medicine.medical_treatment ,Perforation (oil well) ,Case Report ,030204 cardiovascular system & hematology ,Cardiac pacemaker ,Intracolonic ,03 medical and health sciences ,0302 clinical medicine ,Device migration ,Medicine ,Endocarditis ,CIED infection ,Colon perforation ,Lead extraction ,business.industry ,medicine.disease ,Surgery ,Pacemaker ,030228 respiratory system ,Cardiology and Cardiovascular Medicine ,business - Published
- 2018
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39. Periosteal Flap in Cochlear Implantation, How I Do It?
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Yasser Fouad and Thomas Roland
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Adult ,Male ,medicine.medical_specialty ,Prosthesis Design ,Mastoid ,Surgical Flaps ,03 medical and health sciences ,0302 clinical medicine ,Clinical report ,Periosteum ,Device migration ,Humans ,Medicine ,030223 otorhinolaryngology ,Cochlear implantation ,Mastoid foramen ,Implanted device ,Aged ,Delayed wound healing ,Clinical Report ,business.industry ,Infant ,General Medicine ,Middle Aged ,Cochlear Implantation ,Wound infection ,Electrodes, Implanted ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Child, Preschool ,030220 oncology & carcinogenesis ,Female ,Otologic Surgical Procedures ,business ,Ear Canal - Abstract
This clinical report describes and evaluates a novel periosteal flap design. This technique was applied in 26 patients who underwent cochlear implantation surgery at two tertiary referral centers. No complications were observed during or after the surgery. Additionally, there was no evidence of device migration, wound infection, wound hematoma, or delayed wound healing. Notably, the mastoid emissary vein was intact in all cases. In conclusion, this modified anterior-based periosteal flap is a safe procedure and is aimed at avoiding mastoid emissary vein bleeding and allowing complete repositioning of the periosteum over the implanted device.
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- 2018
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40. Intrauterine contraceptive device migration to the urinary bladder
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Suhas Shinde, Mayuri D. Pawar, Gautam S. Aher, and Urmila Gavali
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medicine.medical_specialty ,Urinary bladder ,medicine.anatomical_structure ,business.industry ,Device migration ,Urology ,Medicine ,business ,female genital diseases and pregnancy complications - Abstract
Intravesical migration represent as uncommon complication of intrauterine device insertion. We present a case of an IUD that migrated to the urinary bladder and impacted in urinary bladder wall, causing significant urinary symptoms. A 44 years old woman presented with menorrhagia, lower abdominal pain and urinary symptoms since past 1 year. She reported an IUD insertion 10 years back. Imaging detected the presence of IUD in the urinary bladder wall with large fibroid in uterus. Under anaesthesia, total abdominal hysterectomy with bilateral salphingoophorectomy is performed and IUD was removed out of the bladder without any complications. In her follow-up evaluation after 2 week, she had no urinary symptoms. A regular follow-up of IUD for visible thread would help in earlier detection of misplaced IUD and prevent the complications such as intravesical migration.
- Published
- 2021
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41. Coiling after Treatment with the Woven EndoBridge Cerebral Aneurysm Embolization Device: A Case Report.
- Author
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WALLNER, A. K., BROUSSALIS, E., HAUSER, T., TRINKA, E., and KILLER-OBERPFALZER, M.
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- *
CASE studies , *INTRACRANIAL aneurysms , *ARTIFICIAL implants , *SURGICAL stents , *SURGICAL instruments - Abstract
Retreatment options after the use of the newly launched Woven EndoBridge cerebral aneurysm embolization device (WEB II) are mostly unknown. Nine months after WEB II implantation, a 55-year-old female patient presented with regrowth of an MCA aneurysm. For the first time, standard balloon-assisted coiling was used to close the regrown aneurysm proximal to the WEB II implant. We report on the feasibility and safety of balloon-assisted coiling after implantation of the WEB II device. [ABSTRACT FROM AUTHOR]
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- 2012
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42. Design, Manufacture, and In vivo Testing of a Tissue Scaffold for Permanent Female Sterilization by Tubal Occlusion
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Karen L Moodie, Isabella Caruso, Ulrike G. K. Wegst, Prajan Divakar, P. Jack Hoopes, and Regan N. Theiler
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0301 basic medicine ,Scaffold ,Materials science ,Mechanical Engineering ,Female sterilization ,Biomaterial ,Uterine horns ,02 engineering and technology ,021001 nanoscience & nanotechnology ,Condensed Matter Physics ,03 medical and health sciences ,030104 developmental biology ,Mechanics of Materials ,In vivo ,Tubal occlusion ,Device migration ,General Materials Science ,Scaffold architecture ,0210 nano-technology ,Biomedical engineering - Abstract
Current FDA-approved permanent female sterilization procedures are invasive and/or require the implantation of non-biodegradable materials. These techniques pose risks and complications, such as device migration, fracture, and tubal perforation. We propose a safe, non-invasive biodegradable tissue scaffold to effectively occlude the Fallopian tubes within 30 days of implantation. Specifically, the Fallopian tubes are mechanically de-epithelialized, and a tissue scaffold is placed into each tube. It is anticipated that this procedure can be performed in less than 30 minutes by an experienced obstetrics and gynaecology practitioner. Advantages of this method include the use of a fully bio-resorbable polymer, low costs, lower risks, and the lack of general anaesthesia. The scaffold devices are freeze-cast allowing for the custom-design of structural, mechanical, and chemical cues through material composition, processing parameters, and functionalization. The performance of the biomaterial and de-epithelialization procedure was tested in an in vivo rat uterine horn model. The scaffold response and tissue-biomaterial interactions were characterized microscopically post-implantation. Overall, the study resulted in the successful fabrication of resilient, easy-to-handle devices with an anisotropic scaffold architecture that encouraged rapid bio-integration through notable angiogenesis, cell infiltration, and native collagen deposition. Successful tubal occlusion was demonstrated at 30 days, revealing the great promise of a sterilization biomaterial.
- Published
- 2018
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43. Prosthetic Considerations in Neophallic Reconstruction
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Aaron C. Weinberg, Geolani W. Dy, and Lee C. Zhao
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medicine.medical_specialty ,business.industry ,Urology ,General surgery ,medicine.medical_treatment ,030232 urology & nephrology ,Prosthesis Implantation ,Obstetrics and Gynecology ,Prosthesis ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Increased risk ,030220 oncology & carcinogenesis ,Transgender ,Device migration ,Medicine ,In patient ,Revision rate ,Phalloplasty ,business - Abstract
Phalloplasty may be performed in patients with acquired or congenital penile insufficiency or transgender individuals who desire phallic construction. Demand for neophallus creation and prosthesis placement has increased in recent years with growing coverage for gender affirming surgery among transgender patients. This report describes consideration of prosthetic implantation in neophallic reconstruction. Prosthesis implantation in a neophallus requires special consideration regarding avoidance of critical structures, proximal prosthesis anchoring, and distal cushioning in patients without native corpora cavernosa. Neophallus prostheses are associated with increased risk of infection, extrusion, erosion, and device migration relative to standard prostheses, with a high revision rate. Implanters should have a thorough understanding of neophallic reconstructive technique prior to proceeding with device placement. Current literature on this subject consists predominantly of retrospective reviews and case reports with variable outcome measures. The creation of validated assessment tools will provide more meaningful data to inform provider counseling and patient expectations.
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- 2017
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44. Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children
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Sébastien Hascoët, Alain Fraisse, and Alban-Elouen Baruteau
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Percutaneous ,business.industry ,Septum secundum ,Atrial fibrillation ,030204 cardiovascular system & hematology ,Balloon ,medicine.disease ,Confidence interval ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,medicine ,Cardiology ,Device migration ,Original Article ,Septal Occluder ,business ,Adverse effect - Abstract
Background: 2D-transesophageal echocardiography (TEE) is routinely performed to guide percutaneous ASD closure in children. We aimed to assess whether two-dimensional (2D)-transthoracic echocardiography (TTE) is a safe alternative for assessment and guidance of atrial septal defect (ASD) closure in unselected children. Methods: We performed a retrospective single-center study including 389 consecutive children aged less than 15-year-old who underwent percutaneous ASD closure under 2D-TEE (1998–2005, n=133) or 2D-TTE (2005–2014, n=256). A balloon calibration was performed in all cases for the Amplatz Septal Occluder choice. Results: ASDs were larger and rims deficiencies were more frequent in the TTE-guided group. The procedure was successful in 376 patients [96.7%; 95% confidence interval (CI), 94.4–98.2%]. The success rate tended to be higher in the TTE- versus TEE-guided group (98.0% versus 94.0%, P=0.069). Device migration occurred in 4 patients (1.0%; 95% CI: 0.3–1.6%), all after TEE-guided procedure (P=0.013). Early major adverse events were observed in 5 patients (1.3%; 95% CI: 0.4–3.0%), all in the TEE group (P=0.004). Fluroroscopic time and irradiation dose were not different among the 2 groups (P=0.450 and P=0.130 respectively). After a median follow-up of 7 years (range, 1–16 years), no adverse events was reported. One (0.3%, 95% CI: 0–1.4%) 12-year-old patient developed atrial fibrillation 5 years after the procedure. Pregnancies were uneventful in 72 cases. Conclusions: When a balloon sizing is performed, 2D-TTE imaging is as efficient as 2D-TEE to guide percutaneous ASD closure in children. The procedure can safely be done in spontaneously breathing children under TTE guidance alone in experienced centers.
- Published
- 2017
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45. Hydronephrosis caused by intrauterine contraceptive device migration: three case reports with literature review
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W.H. Zhang, L. Wang, Y.G. He, W. Bai, Y. Li, and X.P. Zhao
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medicine.medical_specialty ,business.industry ,Uterus ,Obstetrics and Gynecology ,medicine.disease ,Surgery ,Peritoneal cavity ,medicine.anatomical_structure ,Ureter ,Reproductive Medicine ,IUD Migration ,medicine ,Device migration ,business ,Hydronephrosis - Abstract
Translocation of intrauterine contraceptive device (IUD) from the uterus rarely occurs, which can lead to serious complications. Here the authors reported three cases of IUD migration from into the ureter, bladder, and peritoneal cavity that caused hydronephrosis, respectively. All the three patients received minimally invasive surgeries and recovered.
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- 2017
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46. Adverse events at the aneurysmal neck identified at follow-up after endovascular abdominal aortic aneursym repair: how do they correlate?
- Author
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Leurs, Lina J., Stultiëns, Guido, Kievit, Jur, Buth, Jaap, Stultiëns, Guido, and EUROSTAR Collaborators
- Subjects
STATISTICAL correlation ,ENDOVASCULAR surgery ,AORTIC aneurysms ,MULTIVARIATE analysis ,PATIENTS ,NECK - Abstract
The objective of this study was to assess the prevalence of and the correlation between dilatation of the infrarenal neck and proximal device migration after endovascular abdominal aortic aneurysm repair (EVAR). The analysis made use of the EUROSTAR registry. Between 1994 and 2004, 4,233 patients with an abdominal aortic aneurysm larger than 4 cm underwent EVAR. Only patients with available follow-up data regarding neck size and device position were included in this assessment. Chi-square and t-tests or Wilcoxon rank sum tests were used for comparison of discrete and continuous variables, respectively. Time-dependent variables were evaluated by log-rank tests. In addition, multivariate analysis was performed to determine anatomic and operative variables with an independent correlation with neck growth and device migration, respectively. In addition, the association with proximal endoleak was assessed. Neck dilatation and proximal migration were found in 1,342 (32%) and 192 (4.5%) of the 4,233 patients, respectively. One hundred twelve patients (2.5%) had neck dilatation and migration of the proximal device extremity. The correlation between proximal migration and neck dilatation was statistically significant (p < .0001). Other independent variables for migration were a wider neck and aneurysmal diameter, shorter necks, proximal endoleak, and absence of suprarenal fixation. Neck dilatation was predicted by narrow necks, use of devices with suprarenal fixation, and larger device diameters. Proximal endoleak occurred in 136 (3.2%) patients and was significantly associated with shorter, angulated necks and proximal migration. The present study documented that migration may be caused by neck dilatation. However, neck dilatation was not significantly promoted by proximal migration. Other factors, such as dimensions of the neck, the device fixation system, and perhaps progressive wall degeneration, are also likely to play a role in the pathogenesis of neck dilatation. To obtain good results from EVAR, accepted criteria of neck dimensions should be adhered to. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
47. Endograft Migration: Incidence, Causes, and Clinical Significance.
- Author
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Lee, Eugene S. and Zarins, Christopher K.
- Abstract
Endovascular device migration is approximately 2% at 1 year using each of the Food and Drug Administration-approved devices (Medtronic AneuRx, Gore Excluder, Cook Zenith). In this report, we review the incidence, causes, and clinical importance of endograft migration over a 5-year period after endovascular aneurysm repair with the AneuRx stent graft. In a multicenter United States clinical trial of the AneuRx device, migration was identified in 8% (94/1119) of patients over a mean follow up time of 30 ± 11 months. A Kaplan-Meier analysis determined migration rates were 1.4% at 1 year, 6.6% at 2 years, and 18.8% at 3 years. The significant factors in device migration appeared to be proximal fixation length (P = .005), renal artery to stent-graft distance (P = .001), and the clinical site (P < .001). Preimplantation aortic neck length, neck diameter, degree of device oversizing, device type (stiff vs flexible), placement of proximal extender cuffs at the original procedure, and postprocedure endoleak were not significant predictors of migration. These results highlight the importance of technical precision in stent-graft deployment as critical in preventing late AneuRx stent graft migration. [ABSTRACT FROM PUBLISHER]
- Published
- 2004
- Full Text
- View/download PDF
48. Wedged Sensor in Distress? Lessons Learned from Troubleshooting Dampened Transmitted PA Waveforms of CardioMEMS Device
- Author
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Robby Singh, Santo Scarfone, and Marcel Zughaib
- Subjects
medicine.medical_specialty ,Pulmonary artery pressure monitoring ,medicine.diagnostic_test ,business.industry ,Device placement ,Case Report ,Troubleshooting ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,Distress ,0302 clinical medicine ,Internal medicine ,Heart failure ,RC666-701 ,Angiography ,Cardiology ,medicine ,Device migration ,Diseases of the circulatory (Cardiovascular) system ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Intensive care medicine - Abstract
Introduction. Cardiovascular disease is a leading cause of morbidity and mortality with heart failure constituting a large portion of this spectrum. Heart failure patients have 90-day readmission rates of nearly 41% associated with a high expense. Numerous strategies to reduce readmissions have been attempted with the CardioMEMS pulmonary artery pressure monitoring system as one of the more successful ones. As this device becomes used more frequently, it is important to recognize procedural complications. We present of a rare complication where a patient underwent successful device placement and was subsequently found to have dampened waveforms which were due to device migration. Case Report. A 79-year-old male underwent successful CardioMEMS placement due to recurrent heart failure hospitalizations. 6 months later, the transmitted waveforms appeared dampened, and repeat angiography revealed a device that had migrated. Rather than abandoning the device, it was recalibrated and continued to transmit data and helped manage the patient’s heart failure. Conclusion. CardioMEMS is a cost-effective tool to help reduce heart failure hospitalizations. Device migration is a rare complication and can lead to inaccurate data. However, as seen in this case, the device can be successfully recalibrated and can continue to be utilized to help reduce heart failure admissions.
- Published
- 2020
49. One Technique to Modulate a Device Implantation Path in a Short Treatment Length Using the Gore IBE Device
- Author
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Yuta Miyano, Hiroshi Mitsuoka, Masanao Nakai, Shin-nosuke Goto, Shinji Kawaguchi, Yasuhiko Terai, and Fumio Yamazaki
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medicine.medical_specialty ,internal iliac artery ,business.industry ,medicine.medical_treatment ,Arterial aneurysm ,Stent ,Economic shortage ,General Medicine ,030204 cardiovascular system & hematology ,Internal iliac artery ,Endovascular aneurysm repair ,Surgery ,endovascular aneurysm repair ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,medicine.artery ,Occlusion ,Device migration ,medicine ,How to Do It ,business ,iliac branch device - Abstract
The GORE EXCLUDER Iliac Branch Endoprosthesis (IBE; W. L. Gore and Associates, Flagstaff, AZ, USA) applicability is limited by the aorto-iliac length (AOL). The shortage may be a major exclusion criterion. An 85-year-old male presented with an abdominal aortic and left common iliac arterial aneurysm. The left-side AOL was 146-mm, which was deemed 19-mm too short for IBE usage. To increase implantation length, the contra-lateral connection stent graft was deployed along the implantation line, wound half-circumferentially around the ipsilateral limb. Any form of endoleak, limb occlusion, and device migration has not been observed for twelve months.
- Published
- 2019
50. Pipeline Embolization Device for Salvage Treatment of a Willis Covered Stent Prolapse Into the Aneurysmal Sac
- Author
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Zeng-Bao Wu, Shiqing Mu, Sheng Wang, Ligang Song, and Xinjian Yang
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Salvage treatment ,endoleak ,Case Report ,migration ,lcsh:RC346-429 ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine ,Device migration ,Embolization ,Covered stent ,lcsh:Neurology. Diseases of the nervous system ,pipeline embolization device ,business.industry ,Stent ,Willis covered stent ,medicine.disease ,Pipeline (software) ,prolapse ,Surgery ,Neurology ,Neurology (clinical) ,business ,Parent vessel ,030217 neurology & neurosurgery - Abstract
The Willis covered stent (WCS) may prolapse into the aneurysmal sac due to device migration or foreshortening. We present a useful salvage strategy that can reorient a prolapsed WCS into a more suitable alignment. An intra-procedural prolapse of a WCS into a large cavernous aneurysm occurred in a 70-year-old female patient. A pipeline embolization device (PED) was used to retrieve the WCS and successfully accomplish flow diversion. Maintaining proximal access and ensuring that the microwire is securely held within the central axis of the herniated stent are critical until the entire parent vessel can be reconstructed. This salvage technique may help to regain proximal access and reposition the flow diversion constructs following WCS prolapse.
- Published
- 2019
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