The Importance Of Endovascular Devices

The endoscopist stand facing the patient holding the instrument in a way it runs in a gentle curve to the patient’s mouth. The control head of the endoscope handled by the palm of the left hand and held between the 4th and 5th fingers and the base of the thumb. The tip of the left thumb rests on the up/down controller. The 1st finger used to activate

The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right

Usually, accessing vascular structures is done through a needle to puncture the vessel percutaneously, followed by a wire introduced through the needle to secure the vascular access. The needle is then removed and a sheath is advanced over the wire. Vascular sheaths are hollow structures with a built in diaphragm to prevent bleeding. Catheters are then placed into and out of the sheath with a minimal loss of blood.11

In this video a patient is having surgery performed on rotator cuff. Usually this kind of surgery is very server to treat. In the video the surgeon inserts an instrument to see what damage is done to the knee joint. While the instrument is inserted the surgeon can monitor the scope on the T.V.Surgery is needed if the shoulder strength does not improve. In the video the instrument used is silver tube about quarter inch in length. The tube is the size of pencil that also has camera so the surgeon can see on the t.v. screen. This kind of surgery is performed under sterile condition. In the video three incisions are cut so there three incisions are only quarter inch in length. Normal saline is used to help with washing out bleeding. This type of surgery involves joints and local anesthesia to be administered. The procedure they are performing is rotator cuff surgery. Personal experience this pass December, I had to have arthroscopy surgery on my right knee I tore my meniscus.

Stent devices were invented in the 1980s and refined in the 1990s. Stenting techniques have transformed and expanded the therapeutic capabilities of angioplasty. There are two classification for stents based on their mode of deployment balloon-expandable and self-expandable. Stents are small mesh tubes which inserted to keep arteries open after angioplasty procedure. Drug -eluting stents have a polymer coating over mesh. This Polymer coatings have been proven to be durable and deliver drug in a uniform and controlled way ( White, Hollier 2007).

A large part of the decision between these two procedures depends on the aneurysms. Factors such as size, location, anatomy and morphology contribute to the treatment team decision as to which procedure would be most beneficial to the patient. During surgical clipping a clip is placed across the neck of the aneurysm cutting off the blood flow to the aneurysm. Singer et al. describes the risks of this procedure being temporary arterial occlusion, intraoperative hemorrhage or new or exacerbated neurologic deficits. The other commonly used surgery, endovascular coiling consist of inserting coils in the lumen of the aneurysm. Thrombus then forms in reaction to the coils and clots off blood flow to the aneurysm, preventing it from rupture or leaking. Complications of this procedure are different from surgical clipping. Aneurysmal rupture and thromboembolism are the main complications of endovascular coiling. Some patients may be placed on a combination of a heparin and or antiplatelet therapy to help prevent a thromboembolic event (Singer et al.). New procedures are being developed for aneurysms such as bypass surgery. This technique redirects blood flow within the brain and uses a built vessel connection to permanently occlude the artery on which the aneurysm sits (Zhang et al. pg. 99). Bypass surgery is more challenging and requires specially trained neurosurgeons for a successful procedure. Decisions and information about regarding the ideal time to treat the aneurysm needs to be addressed as well. There is some controversy about the timing of treatment for both ruptured and unruptured aneurysms. As it in other procedures the risk versus benefits of treating need to be taken into consideration. Risk factors for treating a unuptured aneurysm and having poor outcomes include advanced age and having larger aneurysms. Characteristics of the aneurysm, size,

Catheter angiography can accurately evaluate aortic pararenal patency. This is especially important when placing engrafts at the iliac bifurcation site. CTA is more sensitive to assessing endoleaks occurring after EVAR procedures, but digit subtraction angiography (DSA) is more accurate in classifying endoleaks. This is possible because the direction of flow in or out of the aneurysm site can be evaluated via DSA. Catheter angiography plays a role in imaging intraoperative EVAR patients for endoleak classification and for post-operative re-intervention (Francois et al., 2012). Figure 5 illustrates an arteriogram taken in preparation for an EVAR procedure, while Figure 6 was taken after the EVAR procedure was

Vascular closure devices following cardiac catherization through the femoral artery have been gaining significant traction since its use in the mid-1990s. Compared to the previous gold standard of manual compression, VCDs allow for shortened time to ambulation, decreased duration of hospitalization post procedure, and increased patient comfort. The devices have also shown safeness comparable to manual compression. Despite the many advantages and variety of devices available, there are still complications to take into account. More common issues include device failure, bleeding, and hematoma. Less common but more serious complications include infection, ischemia, limb loss, and death.

Interventional radiologists treat and diagnose disease using imaging equipment. Interventional radiologists sometimes sub-specialise further so that they only treat abnormalities of the brain or spinal cord (neuro intervention) or of the blood vessels other places in the body (angiointervention). Interventional radiology is a minimally invasive procedures using X-ray, magnetic or ultrasound images to help guide the procedures, mainly done with small instruments and very thin plastic tubes called catheters inserted through an artery or vein.

1. Angioplasty: Kereiakes and Wetherill write that “angioplasty is a procedure in which a heart doctor inserts a balloon catheter over a thin wire across an artery. The balloon is inflated and compresses the plaque to clear the arteries of any blockage.”(p. 106-107).

appear similar to conventional stents.”8 Middleton, Teefey and Darcy8 note that the use of PFTE endografts will likely become standard as their performance outweighs the early stent materials used. Color Doppler as well as pulsed Doppler should be used to interrogate the stent and supporting vessels. Velocity measurements are taken using angle correct and spectral waveforms are recorded. Careful examination of the liver vasculature is imperative to verify proper stent function. Specifically, thrombosis or occlusion can be assessed with color and Doppler ultrasound. Velocity parameters may vary from patient to patient and also will change from immediate post procedure velocities to those obtained during long term follow up. Universal Doppler

The ideal purpose of implant is to do the defined task and then dematerialize. The same is expected for the stents inserted in the heart vessels. But unfortunately the conventional stents stays in the body leading to unwanted side effects. Considering advancements from metal stents to present drug eluting stents the ultimate bioabsorbable stent is not yet achievable. With development of such a stent the need of antiplatelet drug will not exist and a person would not have to move around with metal in their body. The ultimate goal of the bioresorbable stent will be leaving the vessels regenerated, resulting in restored functioning. The advantage of the bioabsorbable stent is that if in future there is a need of bypass surgery then the stent would

The Da Vinci Surgical System is a large purpose-built robot controlled by a surgeon that performs minimally invasive surgical procedures on patients. The system incorporates an ergonomically designed surgeon's console, a patient-side module with four interactive robotic arms, each with interchangeable surgical instruments and a 3-dimensional endoscopic vision system. Powered by high-tech supercomputers, the surgeon's hand movements are scaled, filtered and then converted into precise movements of the surgical attachments. The designers of the system are a team of doctors, engineers and biomedical engineers at a company called Intuitive Surgical.

Cardiac catheterization a long flexible thin tube place in blood vessel in arm, groin, or neck looks in coronary arteries. Dye can be added to see how well the heart is pumping.

The medical field has revolutionized the health and well being of society. Throughout the decades, the medical field has been through sweeping changes that leave society astonished. It seems like each year that passes by, there is a new technological advancement that modernizes the medical field. Not only do these advancements modernize medicine, but they in return aid doctors, nurses, and specialists by improving their effectiveness within the field. About ten years ago, the da Vinci Surgical System was introduced to hospitals and the medical field, in general because the FDA had finally approved the system within the United States (Dunkin). The da Vinci Surgical System, also known basically as robotic surgery, introduced the use of a