A self calibrating, magnetic sensor approach accurately positions an aortic damage control stent in a porcine model
Objectives Non-compressible torso hemorrhage remains a high mortality injury, with difficulty mobilizing resources before exsanguination. Previous studies reported on a retrievable stent graft for damage control and morphometric algorithms for rapid placement, yet fluoroscopy is impractical for the...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/8/1/e001220.full |
| _version_ | 1797367301644746752 |
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| author | Yifan Zhang Mahmoud Abdel-Rasoul Dahlia M Kenawy Moataz Elsisy Youngjae Chun William C Clark Bryan W Tillman |
| author_facet | Yifan Zhang Mahmoud Abdel-Rasoul Dahlia M Kenawy Moataz Elsisy Youngjae Chun William C Clark Bryan W Tillman |
| author_sort | Yifan Zhang |
| collection | DOAJ |
| description | Objectives Non-compressible torso hemorrhage remains a high mortality injury, with difficulty mobilizing resources before exsanguination. Previous studies reported on a retrievable stent graft for damage control and morphometric algorithms for rapid placement, yet fluoroscopy is impractical for the austere environment. We hypothesized that magnetic sensors could be used to position stents relative to an external magnet placed on an anatomic landmark, whereas an electromagnet would allow self-calibration to account for environmental noise.Methods A magnetic sensor alone (MSA) and with integrated stent (MSIS) were examined in a porcine model under anesthesia. A target electromagnet was placed on the xiphoid process (position 0 cm). Sensors were placed in the aorta and measurements obtained at positions 0 cm, +4 cm, and +12 cm from the magnet and compared with fluoroscopy. Sensors were examined under conditions of tachycardia/hypertension, hypotension, vibration, and metal shrapnel to simulate environmental factors that might impact accuracy. General linear models compared mean differences between fluoroscopy and sensor readings.Results Both sensors were compatible with a 10 French catheter system and provided real-time assessment of the distance between the sensor and magnetic target in centimeters. Mean differences between fluoroscopy and both magnetic sensor readings demonstrated accuracy within ±0.5 cm for all but one condition at 0 cm and +4 cm, whereas accuracy decreased at +12 cm from the target. Using the control as a reference, there was no significant difference in mean differences between fluoroscopy and both MSA or MSIS readings at 0 cm and +4 cm for all conditions. The system retained effectiveness if the target was overshot.Conclusion Magnetic sensors achieved the highest accuracy as sensors approached the target. Oscillation of the electromagnet on and off effectively accounts for environmental noise.This approach is promising for rapid and accurate placement of damage control retrievable stent grafts when fluoroscopy is impractical.Level of evidence Not applicable. |
| first_indexed | 2024-03-08T17:16:25Z |
| format | Article |
| id | doaj.art-ffbdb58d59814bba868d20fc807213c6 |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2024-03-08T17:16:25Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-ffbdb58d59814bba868d20fc807213c62024-01-03T13:20:08ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762023-11-018110.1136/tsaco-2023-001220A self calibrating, magnetic sensor approach accurately positions an aortic damage control stent in a porcine modelYifan Zhang0Mahmoud Abdel-Rasoul1Dahlia M Kenawy2Moataz Elsisy3Youngjae Chun4William C Clark5Bryan W Tillman6Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USABiomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USASurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USASwanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USASwanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USASwanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USASurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USAObjectives Non-compressible torso hemorrhage remains a high mortality injury, with difficulty mobilizing resources before exsanguination. Previous studies reported on a retrievable stent graft for damage control and morphometric algorithms for rapid placement, yet fluoroscopy is impractical for the austere environment. We hypothesized that magnetic sensors could be used to position stents relative to an external magnet placed on an anatomic landmark, whereas an electromagnet would allow self-calibration to account for environmental noise.Methods A magnetic sensor alone (MSA) and with integrated stent (MSIS) were examined in a porcine model under anesthesia. A target electromagnet was placed on the xiphoid process (position 0 cm). Sensors were placed in the aorta and measurements obtained at positions 0 cm, +4 cm, and +12 cm from the magnet and compared with fluoroscopy. Sensors were examined under conditions of tachycardia/hypertension, hypotension, vibration, and metal shrapnel to simulate environmental factors that might impact accuracy. General linear models compared mean differences between fluoroscopy and sensor readings.Results Both sensors were compatible with a 10 French catheter system and provided real-time assessment of the distance between the sensor and magnetic target in centimeters. Mean differences between fluoroscopy and both magnetic sensor readings demonstrated accuracy within ±0.5 cm for all but one condition at 0 cm and +4 cm, whereas accuracy decreased at +12 cm from the target. Using the control as a reference, there was no significant difference in mean differences between fluoroscopy and both MSA or MSIS readings at 0 cm and +4 cm for all conditions. The system retained effectiveness if the target was overshot.Conclusion Magnetic sensors achieved the highest accuracy as sensors approached the target. Oscillation of the electromagnet on and off effectively accounts for environmental noise.This approach is promising for rapid and accurate placement of damage control retrievable stent grafts when fluoroscopy is impractical.Level of evidence Not applicable.https://tsaco.bmj.com/content/8/1/e001220.full |
| spellingShingle | Yifan Zhang Mahmoud Abdel-Rasoul Dahlia M Kenawy Moataz Elsisy Youngjae Chun William C Clark Bryan W Tillman A self calibrating, magnetic sensor approach accurately positions an aortic damage control stent in a porcine model Trauma Surgery & Acute Care Open |
| title | A self calibrating, magnetic sensor approach accurately positions an aortic damage control stent in a porcine model |
| title_full | A self calibrating, magnetic sensor approach accurately positions an aortic damage control stent in a porcine model |
| title_fullStr | A self calibrating, magnetic sensor approach accurately positions an aortic damage control stent in a porcine model |
| title_full_unstemmed | A self calibrating, magnetic sensor approach accurately positions an aortic damage control stent in a porcine model |
| title_short | A self calibrating, magnetic sensor approach accurately positions an aortic damage control stent in a porcine model |
| title_sort | self calibrating magnetic sensor approach accurately positions an aortic damage control stent in a porcine model |
| url | https://tsaco.bmj.com/content/8/1/e001220.full |
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