An Implantable Magnetic Drive Mechanism for Non-Invasive Arteriovenous Conduit Blood Flow Control.
| Autor: | White NA, van der Kroft SL, van der Bogt KEA, Vrielink TJCO, Camenzuli C, Calleja-Agius J, Sanchez-Margallo JA, Sanchez-Margallo FM, van de Stadt HJF, Dankelman J, Rotmans JI, Horeman T |
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| Jazyk: | angličtina |
| Zdroj: | IEEE transactions on bio-medical engineering [IEEE Trans Biomed Eng] 2024 Aug; Vol. 71 (8), pp. 2379-2390. Date of Electronic Publication: 2024 Jul 18. |
| DOI: | 10.1109/TBME.2024.3370263 |
| Abstrakt: | Objective: Hemodialysis patients usually receive an arteriovenous fistula (AVF) in the arm as vascular access conduit to allow dialysis 2-3 times a week. This AVF introduces the high flow necessary for dialysis, but over time the ever-present supraphysiological flow is the leading cause of complications. This study aims to develop an implantable device able to non-invasively remove the high flow outside dialysis sessions. Methods: The developed prototype features a magnetic ring allowing external coupling and torque transmission to non-invasively control an AVF valve. Mock-up devices were implanted into arm and sheep cadavers to test sizes and locations. The transmission torque, output force, and valve closure are measured for different representative skin thicknesses. Results: The prototype was placed successfully into arm and sheep cadavers. In the prototype, a maximum output force of 78.9 ± 4.2 N, 46.7 ± 1.9 N, 25.6 ± 0.7 N, 13.5 ± 0.6 N and 6.3 ± 0.4 N could be achieved non-invasively through skin thicknesses of 1-5 mm respectively. The fistula was fully collapsible in every measurement through skin thickness up to the required 4 mm. Conclusion: The prototype satisfies the design requirements. It is fully implantable and allows closure and control of an AVF through non-invasive torque transmission. In vivo studies are pivotal in assessing functionality and understanding systemic effects. Significance: A method is introduced to transfer large amounts of energy to a medical implant for actuation of a mechanical valve trough a closed surface. This system allows non-invasive control of an AVF to reduce complications related to the permanent high flow in conventional AVFs. |
| Databáze: | MEDLINE |
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