| Autor: |
White, Nicholas A., van der Kroft, Sander L., van der Bogt, Koen E.A., Vrielink, Timo J.C. Oude, Camenzuli, Christian, Calleja-Agius, Jean, Sanchez-Margallo, Juan A., Sanchez-Margallo, Francisco M., van de Stadt, Huybert J.F., Dankelman, Jenny, Rotmans, Joris I., Horeman, Tim |
| Zdroj: |
IEEE Transactions on Biomedical Engineering; August 2024, Vol. 71 Issue: 8 p2379-2390, 12p |
| 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: |
Supplemental Index |
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