A review of robot-assisted ultrasound examination: Systems and technology.

BACKGROUND: At present, the number and overall level of ultrasound (US) doctors cannot meet the medical needs, and the medical ultrasound robots will largely solve the shortage of medical resources. METHODS: According to the degree of automation, the handheld, semi-automatic and automatic ultrasound examination robot systems are summarised. Ultrasound scanning path planning and robot control are the keys to ensure that the robot systems can obtain high-quality images. Therefore, the ultrasound scanning path planning and control methods are summarised. The research progress and future trends are discussed. RESULTS: A variety of ultrasound robot systems have been applied to various medical works. With the continuous improvement of automation, the systems provide high-quality ultrasound images and image guidance for clinicians. CONCLUSION: Although the development of medical ultrasound robot still faces challenges, with the continuous progress of robot technology and communication technology, medical ultrasound robot will have great development potential and broad application space.

A prostate seed implantation robot system based on human-computer interactions: Augmented reality and voice control.

The technology of robot-assisted prostate seed implantation has developed rapidly. However, during the process, there are some problems to be solved, such as non-intuitive visualization effects and complicated robot control. To improve the intelligence and visualization of the operation process, a voice control technology of prostate seed implantation robot in augmented reality environment was proposed. Initially, the MRI image of the prostate was denoised and segmented. The three-dimensional model of prostate and its surrounding tissues was reconstructed by surface rendering technology. Combined with holographic application program, the augmented reality system of prostate seed implantation was built. An improved singular value decomposition three-dimensional registration algorithm based on iterative closest point was proposed, and the results of three-dimensional registration experiments verified that the algorithm could effectively improve the three-dimensional registration accuracy. A fusion algorithm based on spectral subtraction and BP neural network was proposed. The experimental results showed that the average delay of the fusion algorithm was 1.314 s, and the overall response time of the integrated system was 1.5 s. The fusion algorithm could effectively improve the reliability of the voice control system, and the integrated system could meet the responsiveness requirements of prostate seed implantation.

A review on tissue-needle interaction and path planning models for bevel tip type flexible needle minimal intervention.

A flexible needle has emerged as a crucial clinical technique in contemporary medical practices, particularly for minimally invasive interventions. Its applicability spans diverse surgical domains such as brachytherapy, cardiovascular surgery, neurosurgery and others. Notably, flexible needles find utility in biopsies requiring deep skin penetration to access infected areas. Despite its minimally invasive advantages, the precise guidance of the needle to its intended target, while avoiding damage to bones, blood vessels, organs and tissues, remains a significant challenge for researchers. Consequently, extensive research has been dedicated to enhancing the steering and accuracy of flexible needles. Here, we aim to elucidate the recent advancements, trends and perspectives in flexible needle steering models and path planning over the last 15 years. The discussed models encompass various types, including symmetric-tip needles, curved-tip needles, tendon-actuated needles, programmable needles and the innovative fracture-directed waterjet needles. Moreover, the paper offers a comprehensive analysis, comparing the trajectories followed by these needle models to attain the desired target with minimal tissue damage. By delving into these aspects, the paper contributes to a deeper understanding of the current landscape of flexible needle technology and guides future research directions in this dynamic field.

Enhanced NIR-II Fluorescent Lateral Flow Biosensing Platform Based on Supramolecular Host-Guest Self-Assembly for Point-of-Care Testing of Tumor Biomarkers.

Point-of-care detection of tumor biomarkers with high sensitivity remains an enormous challenge in the early diagnosis and mass screening of cancer. Fluorescent lateral flow immunoassay (LFA) is an attractive platform for point-of-care testing due to its inherent advantages. Particularly, a fluorescent probe is crucial to improving the analytical performance of the LFA platform. Herein, we developed an enhanced second near-infrared (NIR-II) LFA (ENIR-II LFA) platform based on supramolecular host-guest self-assembly for detection of the prostate-specific antigen (PSA) as a model analyte. In this platform, depending on the effective supramolecular surface modification strategy, cucurbit[7]uril (CB[7])-covered rare-earth nanoparticles (RENPs) emitting in the NIR-II (1000-1700 nm) window were prepared and employed as an efficient fluorescent probe (RENPs-CB[7]). Benefiting from its superior optical properties, such as low autofluorescence, excellent photostability, enhanced fluorescence intensity, and increased antibody-conjugation efficiency, the ENIR-II LFA platform displayed a wide linear detection range from 0.65 to 120 ng mL-1, and the limit of detection was down to 0.22 ng mL-1 for PSA, which was 18.2 times lower than the clinical cutoff value. Moreover, the testing time was also shortened to 6 min. Compared with the commercial visible fluorescence LFA kit (VIS LFA) and the previously reported NIR-II LFA based on a RENPs-PAA probe, this ENIR-II LFA demonstrated more competitive advantages in analytical sensitivity, detection range, testing time, and production cost. Overall, the ENIR-II LFA platform offers great potential for the highly sensitive, rapid, and convenient detection of tumor biomarkers and is expected to serve as a useful technique in the general population screening of the high-incidence cancer region.

Image-guided prostate biopsy robots: A review.

At present, the incidence of prostate cancer (PCa) in men is increasing year by year. So, the early diagnosis of PCa is of great significance. Transrectal ultrasonography (TRUS)-guided biopsy is a common method for diagnosing PCa. The biopsy process is performed manually by urologists but the diagnostic rate is only 20%-30% and its reliability and accuracy can no longer meet clinical needs. The image-guided prostate biopsy robot has the advantages of a high degree of automation, does not rely on the skills and experience of operators, reduces the work intensity and operation time of urologists and so on. Capable of delivering biopsy needles to pre-defined biopsy locations with minimal needle placement errors, it makes up for the shortcomings of traditional free-hand biopsy and improves the reliability and accuracy of biopsy. The integration of medical imaging technology and the robotic system is an important means for accurate tumor location, biopsy puncture path planning and visualization. This paper mainly reviews image-guided prostate biopsy robots. According to the existing literature, guidance modalities are divided into magnetic resonance imaging (MRI), ultrasound (US) and fusion image. First, the robot structure research by different guided methods is the main line and the actuators and material research of these guided modalities is the auxiliary line to introduce and compare. Second, the robot image-guided localization technology is discussed. Finally, the image-guided prostate biopsy robot is summarized and suggestions for future development are provided.

Flexible Needle Steering with Tethered and Untethered Actuation: Current States, Targeting Errors, Challenges and Opportunities.

Accurate needle targeting is critical for many clinical procedures, such as transcutaneous biopsy or radiofrequency ablation of tumors. However, targeting errors may arise, limiting the widespread adoption of these procedures. Advances in flexible needle (FN) steering are emerging to mitigate these errors. This review summarizes the state-of-the-art developments of FNs and addresses possible targeting errors that can be overcome with steering actuation techniques. FN steering techniques can be classified as passive and active. Passive steering directly results from the needle-tissue interaction forces, whereas active steering requires additional forces to be applied at the needle tip, which enhances needle steerability. Therefore, the corresponding targeting errors of most passive FNs and active FNs are between 1 and 2 mm, and less than 1 mm, respectively. However, the diameters of active FNs range from 1.42 to 12 mm, which is larger than the passive steering needle varying from 0.5 to 1.4 mm. Therefore, the development of active FNs is an area of active research. These active FNs can be steered using tethered internal direct actuation or untethered external actuation. Examples of tethered internal direct actuation include tendon-driven, longitudinal segment transmission and concentric tube transmission. Tendon-driven FNs have various structures, and longitudinal segment transmission needles could be adapted to reduce tissue damage. Additionally, concentric tube needles have immediate advantages and clinical applications in natural orifice surgery. Magnetic actuation enables active FN steering with untethered external actuation and facilitates miniaturization. The challenges faced in the fabrication, sensing, and actuation methods of FN are analyzed. Finally, bio-inspired FNs may offer solutions to address the challenges faced in FN active steering mechanisms.

Review of research on path planning and control methods of flexible steerable needle puncture robot.

In the field of minimally invasive interventional therapy, the related research on the soft tissue puncture robot and its technology based on the flexible steerable needle as a research hot topic at present, and it has been developed rapidly in the past ten years. In order to better understand the development status of the flexible steerable needle puncture (FSNP) robot and provide reference for its design and improvement in subsequent research, it is necessary to introduce in two aspects of FSNP robot: the puncture path planning and the control methods. First, this article introduced the concept of the FSNP technology, and the necessity of the application of FSNP soft tissue robot in minimally invasive interventional surgery. Second, this article mainly introduced the principle of FSNP, the path planning of FSNP, the navigation and positioning control of the needle tip of the flexible steerable needle, the control method of FSNP system, and the controllable flexible needle. Finally, combined with the above analysis and introduction, it was pointed out that FSNP soft tissue robot and its related technology would be an important development direction in the field of minimally invasive interventional therapy in the future, and the current existing problems were pointed out. Meanwhile, the development trend of FSNP robot control technology was summarized and prospected.

A needle deflection model with operating condition optimization for corrective force-based needle guidance during transrectal prostate brachytherapy.

BACKGROUND: Transrectal prostate brachytherapy (BT) involves the permanent implantation of radioactive seeds through a needle, which must be inserted along a straight path to satisfy dose distribution requirements. However, this process is complicated by bevelled needle tips that can cause deflection during penetration. In clinical practice, physicians typically rotate the bevelled tip intermittently or apply manual correction forces near the insertion point, to reduce needle deflection. While assisted rotational insertion robots have made substantial progress in the past 20 years, tissue sticking can be caused by rotation of the bevelled tip and there are currently few studies on the use of corrective forces. As such, an auxiliary needle insertion guide for transrectal prostate BT, based on corrective forces, is investigated in this study for the first time. METHODS: The proposed BT guide is designed to reduce needle deflection and was experimentally verified by in vitro experiments. An energy-based deflection model was developed to predict needle motion as corrective forces were applied during insertion. An experimental platform was constructed to perform corrective force-assisted punctures, using the magnitude of the corrective force (A), the position of corrective force application (B) and the puncture speed (C) as test factors, with needle deflection as a test indicator. Design-Expert 8.0.5b software was used for simulation, and a high-definition camera acquired pictures of the needle tip as it pierced the tissue. A regression equation was also established for the test factors and test indicators, using Design-Expert software. Optimal parameter combinations (A, B and C) were determined through optimization. RESULTS: Calculated needle deflection values were then compared with the measured position of the needle insertion point, producing an average error of 0.39 ± 0.28 mm. Deflection was as low as 0.8 mm using optimal puncture parameters CONCLUSIONS: A needle-tissue interaction model, considering tissue nonlinearity, which experimental results demonstrated to be highly accurate. Optimal puncture parameters effectively improved puncture accuracy.

Nxhl Controls Angiogenesis by Targeting VE-PTP Through Interaction With Nucleolin.

Precise regulation of angiogenesis is required for organ development, wound repair, and tumor progression. Here, we identified a novel gene, nxhl (New XingHuo light), that is conserved in vertebrates and that plays a crucial role in vascular integrity and angiogenesis. Bioinformatic analysis uncovered its essential roles in development based on co-expression with several key developmental genes. Knockdown of nxhl in zebrafish causes global and pericardial edema, loss of blood circulation, and vascular defects characterized by both reduced vascularization in intersegmental vessels and decreased sprouting in the caudal vein plexus. The nxhl gene also affects human endothelial cell behavior in vitro. We found that nxhl functions in part by targeting VE-PTP through interaction with NCL (nucleolin). Loss of ptprb (a VE-PTP ortholo) in zebrafish resulted in defects similar to nxhl knockdown. Moreover, nxhl deficiency attenuates tumor invasion and proteins (including VE-PTP and NCL) associated with angiogenesis and EMT. These findings illustrate that nxhl can regulate angiogenesis via a novel nxhl-NCL-VE-PTP axis, providing a new therapeutic target for modulating vascular formation and function, especially for cancer treatment.

A review of the research progress of interventional medical equipment and methods for prostate cancer.

BACKGROUND: Prostate cancer is a common disease in men and has a relatively high mortality rate. However, the interventional medical equipment used for prostate biopsy and brachytherapy has always been a social concern. METHODS: To understand interventional medical equipment for prostate cancer, the structure of manual, semi-automatic and automatic medical equipment were considered as the mainline, while the corresponding research on these structures were the auxiliary lines. The characteristics and corresponding research status have been discussed. RESULTS: Interventional medical equipment for prostate cancer with different degrees of automation and its characteristics were determined, and the imaging principles and characteristics of computed tomography, transrectal ultrasound and magnetic resonance imaging have been briefly described. CONCLUSION: Certain feasible research suggestions have been proposed for future development from the perspective of structure, accuracy and safety. These include flexible and compact robot structures, high-precision image recognition and guidance, accurate dose planning and monitoring, real-time imaging monitoring without delay, high-precision needle insertion strategy, master-slave control, virtual reality and remote control.

Image-guided robots for low dose rate prostate brachytherapy: Perspectives on safety in design and use.

BACKGROUND: Image-guided brachytherapy (BT) robots can be used to assist urologists during seed implantation, thereby improving therapeutic effects. However, safety issues must be considered in the design of such robots, including their structure, mechanical movements, function, materials and actuators. Previous reviews focused on image-guided prostate BT robot technology (e.g., imaging and robot navigation technology and robot system introduction); however, this review is the first time that safety issues have been investigated as part of a study on low-dose-rate (LDR) prostate BT robots. METHODS: Multiple electronic databases were searched for LDR prostate BT robot articles published during the last 24 years (1996-2020), with a particular focus on two aspects of robots: safety in design and use. RESULTS: We retrieved a total of 26 LDR prostate BT robots. BT robots were divided into ultrasound, computed tomography, magnetic resonance imaging and fusion-guided systems. The conditions associated with each system were then analysed to develop a set of requirements for the safety of prostate BT robots. Recommendations are also provided for future BT robot development. CONCLUSIONS: The transrectal approach for prostate seed implantation is safer than the traditional transperineal approach. Research into the control of a steerable needle by the urologists and robot, the needle deflection model, and robotic automated needle changing and seed injection equipment should be pursued in a future study.

Design and control of a bionic needle puncture robot.

BACKGROUND: The application of minimally invasive interventional breast surgery is becoming more and more widespread. The accurate puncture of breast cancer needs to solve the problems of tissue deformation and target displacement. METHODS: In this study, we analysed the process of leech blood absorption and developed a robotic needle insertion method based on bionic technology to improve the accuracy of breast cancer diagnosis and treatment. Among them, the design purpose of the sucker manipulator is to adjust and fix the breast tissue. We use uncalibrated visual servo to control soft tissue deformation. RESULTS: We compare the puncture effect of bionic needle puncture robot and common needle puncture on breast prosthesis and in vitro tissue. Experimental data shows that, compared with ordinary needle insertion, the robotic needle insertion method based on bionic technology greatly reduces the targeting error. CONCLUSIONS: This method is expected to provide a safe and effective alternative to traditional puncture for breast cancer diagnosis and treatment.

Design and experimental study of a novel 7-DOF manipulator for transrectal ultrasound probe.

Traditional hand-held ultrasound probe has some limitations in prostate biopsy. Improving the localization and accuracy of ultrasound probe will increase the detection rate of prostate cancer while biopsy techniques remain unchanged. This paper designs a manipulator for transrectal ultrasound probe, which assists doctors in performing prostate biopsy and improves the efficiency and accuracy of biopsy procedure. The ultrasound probe manipulator includes a position adjustment module that can lock four joints at the same time. It reduces operating time and improves the stability of the mechanism. We use the attitude adjustment module designed by double parallelogram RCM mechanism, the ultrasound probe can realize centering and prevent its radial motion. The self-weight balance design helps doctors operate ultrasound probe without weight. Using MATLAB to analyze the manipulator, the results show that the workspace of the mechanism can meet the biopsy requirements. And simulate the centering effect of the ultrasound probe when the attitude is adjusted at different feeding distances, the results show that the ultrasound probe is centering stability. Finally, the centering and joint interlocking tests of the physical prototype are completed. In this paper, a 7-DOF manipulator for transrectal ultrasound probe is designed. The mechanism is analyzed for kinematics, workspace analysis, simulation of centering effects, development of a physical prototype and related experimental research. The results show that the surgical demand workspace is located inside the reachable workspace of the mechanism and the joint locking of the manipulator is reliable.

Design and Experiment of Assistive Mechanism for Adjustment of Transrectal Ultrasound Probe.

Transrectal ultrasound prostate biopsy is the most commonly used method for the diagnosis of prostate cancer. During the operation, the doctor needs to manually adjust the ultrasound probe for repeated adjustments, which is difficult to ensure the efficiency, accuracy, and safety of the operation. This paper presents a passive posture adjusting mechanism of transrectal ultrasound probe. The overall mechanism has 7 degrees of freedom, consisting of a position adjustment module, a posture adjustment module, and an ultrasonic probe rotation and feed module. In order to achieve the centering function, the posture adjustment module is designed based on the double parallelogram. Centering performance is verified based on SimMechanics, and remote center point error of physical prototypes is evaluated. The maximum error of the azimuth remote center point motion and the maximum error of the remote center point motion of the ultrasonic probe are 4 mm and 3.4 mm, respectively, which are less than the anus that can withstand 6 mm. Meanwhile, the analysis of measurement error shows that the random error correlation is weak in different directions, the systematic error confidence intervals of azimuth and elevation angle are less than 2.5 mm, and the maximum relative fixed point error and the maximum relative standard error are 14.73% and 14.98%, respectively. The simulation and testing results have shown the effectiveness and reliability of the propose mechanism.

A review of recent advancements in soft and flexible robots for medical applications.

BACKGROUND: Soft and flexible robots for medical applications are needed to change their flexibility over a wide range to perform tasks adequately. The mechanism and theory of flexibility has been a scientific issue and is of interest to the community. METHODS: Recent advancements of bionics, flexible actuation, sensing, and intelligent control algorithms as well as tunable stiffness have been referenced when soft and flexible robots are developed. The benefits and limitations of these relevant studies and how they affect the flexibility are discussed, and possible research directions are explored. RESULTS: The bionic materials and structures that demonstrate the potential capabilities of the soft medical robot flexibility are the fundamental guarantee for clinical medical applications. Flexible actuation that used to provide power, intelligent control algorithms which are the exact executors, and the wide range stiffness of the soft materials are the three important influence factors for soft medical robots. CONCLUSION: Some reasonable suggestions and possible solutions for soft and flexible medical robots are proposed, including novel materials, flexible actuation concepts with a built-in source of energy or power, programmable flexibility, and adjustable stiffness.

Design Analysis and Experimental Study of Robotic Chair for Proton Heavy Ion Radiotherapy.

Proton heavy ion radiotherapy is widely used and currently represents the most advanced radiotherapy technology. However, at present, proton heavy ion radiotherapy chairs in fixed beam radiotherapy rooms do not have a head and neck positioning function. This paper presents a novel design for a proton heavy ion radiotherapy chair with a head and neck positioning device. The design of the posture adjustment mechanism and the head and neck positioning device of the treatment chair is based on U-TRIZ theory and ergonomics, respectively. A positive kinematic analysis of the posture adjusting mechanism was carried out, as well as a workspace analysis of the head and neck positioning device. Finally, positioning error experiment and ergonomic evaluation were performed on a prototype of the head and neck positioning device. The proposed design of the treatment chair satisfies the requirements for posture adjustment and achieves the head and neck positioning function. The experimental results also provide a basis for further optimization of the design.

Design and experimentation with sandwich microstructure for catalytic combustion-type gas sensors.

The traditional handmade catalytic combustion gas sensor has some problems such as a pairing difficulty, poor consistency, high power consumption, and not being interchangeable. To address these issues, integrated double catalytic combustion of alcohol gas sensor was designed and manufactured using silicon micro-electro-mechanical systems (MEMS) technology. The temperature field of the sensor is analyzed using the ANSYS finite element analysis method. In this work, the silicon oxide-PECVD-oxidation technique is used to manufacture a SiO2-Si3N2-SiO2 microstructure carrier with a sandwich structure, while wet etching silicon is used to form a beam structure to reduce the heat consumption. Thin-film technology is adopted to manufacture the platinum-film sensitive resistance. Nano Al2O3-ZrO-ThO is coated to format the sensor carrier, and the sensitive unit is dipped in a Pt-Pd catalyst solution to form the catalytic sensitive bridge arm. Meanwhile the uncoated catalyst carrier is considered as the reference unit, realizing an integrated chip based on a micro double bridge and forming sensors. The lines of the Pt thin-film resistance have been observed with an electronic microscope. The compensation of the sensitive material carriers and compensation materials have been analyzed using an energy spectrum. The results show that the alcohol sensor can detect a volume fraction between 0 and 4,500 × 10(-6) and has good linear output characteristic. The temperature ranges from -20 to +40 °C. The humidity ranges from 30% to 85% RH. The zero output of the sensor is less than ±2.0% FS. The power consumption is ≤0.2 W, and both the response and recovery time are approximately 20 s.

Motion planning and synchronized control of the dental arch generator of the tooth-arrangement robot.

BACKGROUND: The traditional, manual method of reproducing the dental arch form is prone to numerous random errors caused by human factors. The purpose of this study was to investigate the automatic acquisition of the dental arch and implement the motion planning and synchronized control of the dental arch generator of the multi-manipulator tooth-arrangement robot for use in full denture manufacture. METHODS: First, the mathematical model of the dental arch generator was derived. Then the kinematics and control point position of the dental arch generator of the tooth arrangement robot were calculated and motion planning of each control point was analysed. A hardware control scheme is presented, based on the industrial personal computer and control card PC6401. In order to gain single-axis, precise control of the dental arch generator, we studied the control pulse realization of high-resolution timing. Real-time, closed-loop, synchronous control was applied to the dental arch generator. Experimental control of the dental arch generator and preliminary tooth arrangement were gained by using the multi-manipulator tooth-arrangement robotic system. RESULTS: The dental arch generator can automatically generate a dental arch to fit a patient according to the patient's arch parameters. Repeated positioning accuracy is 0.12 mm for the slipways that drive the dental arch generator. The maximum value of single-point error is 1.83 mm, while the arc-width direction (x axis) is -33.29 mm. CONCLUSION: A novel system that generates the dental arch has been developed. The traditional method of manually determining the dental arch may soon be replaced by a robot to assist in generating a more individual dental arch. The system can be used to fabricate full dentures and bend orthodontic wires.

Coordinated control and experimentation of the dental arch generator of the tooth-arrangement robot.

BACKGROUND: The traditional way of acquiring the dental arch curve form is based on manual operation, which will randomly bring numerous errors caused by human factors. The purpose of this paper is to automatically acquire the dental arch curve and implement the coordinated control of the dental arch generator of the multi-manipulator tooth-arrangement robot, which can be used in full denture manufacturing. METHODS: Based on the arc length constant theory, kinematics on dental arch generator is analyzed. The control pulse realization methods of high-resolution timing and CPU time-stamp timing are studied, and testing and comparative analysis of the control precision and stability of the two methods is carried out. Control experimentation of the dental arch generator and preliminary tooth-arrangement experimentation are performed using the multi-manipulator tooth-arrangement robot system. RESULTS: The dental arch generator can automatically generate a dental arch curve that fits a patient according to the patient's jaw arch parameters. Repeated positioning accuracy is 0.12 mm for the slipways which drive the dental arch generator. The maximum value of single point error is 1.64 mm when the arc width direction (x-axis) is 37.25 mm. The experimental results indicate that the method of control pulse realized by high-resolution timing to achieve high precision coordinated motion control of dental arch generator of tooth-arrangement robot is feasible. The error analysis results indicate that the control strategy and technical route can fulfill the requirements for motion speed and location precision. CONCLUSION: A novel system to generate the tooth arch curve has been developed. The traditional method of manually determining the dental arch may soon become obsolete in favour of the use of a robot to assist in generating a more standard tooth arch curve. The system can be used to manufacture a full denture. It will lay an important theoretical foundation for quantitative research of oral restoration, and also provide a way to standardize the manufacturing process of full denture.

Structural and electrophysiological changes in atherosclerotic radial artery grafts account for impairment of vessel reactivity.

To evaluate the potential impact of using atherosclerotic radial artery (RA) conduits as grafts in coronary artery bypass surgery, we examined the vasoconstrictor and electrophysiological properties of mildly and severely atherosclerotic RAs. Vasoconstrictor responses were measured in cannulated and pressurized (85mmHg) RA segments and K(+) currents were measured in single smooth muscle cells. In the cannulated and pressurized vessel preparation, the pressure-induced dilation was attenuated in both the mildly and severely atherosclerotic RAs when compared to normal samples. Contractile responses to potassium chloride, thromboxane A(2) (TXA(2)) analog U-46619 and to E-ring and F-ring isoprostanes were also attenuated. Smooth muscle cells (SMCs) from atherosclerotic arteries manifested significantly greater K(+) current density (76.6+/-22.4pA/pF) when compared to normal SMCs (18.6+/-3.3pA/pF). Our results show that vasocontractile properties of both mildly and severely atherosclerotic arteries are reduced when compared to normal RAs. A possible explanation for this could be decreased vascular compliance due to arterial stiffening and a substantial augmentation of K(+) currents in sclerotic smooth muscle cells. We conclude that caution should be exercised when using RA grafts with atherosclerotic lesions since they could significantly impact the clinical outcome of CABG surgery.