Aspiration Thrombectomy versus Conventional Catheter-Directed Thrombolysis as First-Line Treatment for Noniatrogenic Acute Lower Limb Ischemia.

PURPOSE: To examine the efficacy, safety, and procedural costs of percutaneous aspiration thrombectomy (PAT) as a first-line treatment for noniatrogenic acute lower limb ischemia (ALI) compared with conventional catheter-directed thrombolysis (CDT). MATERIALS AND METHODS: All patients who underwent endovascular intervention for ALI from January 2015 to August 2017 were included. Fifteen patients were treated with the use of primary PAT and 27 patients were treated with the use of primary CDT. The primary end point was complete thrombus clearance with improvement in Thrombolysis in Myocardial Infarction (TIMI) score. Adjunctive treatment for thrombus removal was considered to indicate technical failure. Treatment of underlying chronic disease was not considered to indicate technical failure. Procedural costs for each patient were calculated by itemizing all disposable equipment, facility overheads, and staff costs. RESULTS: Of the 15 primary PAT patients, technical success was achieved in 8 (53%); the remaining 7 (47%) required adjunctive CDT. Of the 27 primary CDT patients, technical success was achieved in 25 (89%); the remaining 2 (11%) required adjunctive PAT. There were 4 complications in the primary PAT group: 2 were procedure related and of a minor grade. There were 8 complications in the primary CDT group: All were procedure-related, including 2 major groin/retroperitoneal hemorrhage and 1 death from intracranial hemorrhage. Limb salvage was attained in all patients. There were no significant differences in average procedural costs per patient between the 2 groups. CONCLUSIONS: First-line use of PAT for endovascular treatment of ALI can reduce the need for CDT, with no significant cost difference.

Characterization of a novel two-finger variable reluctance gripper.

Variable reluctance (VR) actuator has a simple and robust structure. Without any permanent magnet, it is low cost; easy to manufacture, highly reliable, and can operate in hostile temperatures. However, it is inherently nonlinear, and is difficult to control and operate as a proportional device. With the advancement of digital signal processors and power electronic drives in recent years, advance modeling techniques and control solutions can be realized onto VR actuators applications. For these reasons, VR actuators have redrawn research interests. The paper describes the investigation and development of a novel two-finger gripper using VR technology. A novel two-finger VR gripper has been proposed and fabricated. Characterization measurements of the VR gripper were carried out. Measurement results show that the proposed actuator exhibits general characteristics as VR actuators and becomes more efficient through making use of mutual coupling.