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1.
Proc Biol Sci ; 287(1931): 20201135, 2020 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-33043863

RESUMO

Tardigrades have a miniaturized body plan. Miniaturization in tardigrades is associated with the loss of several organ systems and an intermediate region of their anteroposterior (AP) axis. However, how miniaturization has affected tardigrade legs is unclear. In arthropods and in onychophorans, the leg gap genes are expressed in regionalized proximodistal (PD) patterns in the legs. Functional studies indicate that these genes regulate growth in their respective expression domains and establish PD identities, partly through mutually antagonistic regulatory interactions. Here, we investigated the expression patterns of tardigrade orthologs of the leg gap genes. Rather than being restricted to a proximal leg region, as in arthropods and onychophorans, we detected coexpression of orthologues of homothorax and extradenticle broadly across the legs of the first three trunk segments in the tardigrade Hypsibius exemplaris. We could not identify a dachshund orthologue in tardigrade genomes, a gene that is expressed in an intermediate region of developing legs in arthropods and onychophorans, suggesting that this gene was lost in the tardigrade lineage. We detected Distal-less expression broadly across all developing leg buds in H. exemplaris embryos, unlike in arthropods and onychophorans, in which it exhibits a distally restricted expression domain. The broad expression patterns of the remaining leg gap genes in H. exemplaris legs may reflect the loss of dachshund and the accompanying loss of an intermediate region of the legs in the tardigrade lineage. We propose that the loss of intermediate regions of both the AP and PD body axes contributed to miniaturization of Tardigrada.


Assuntos
Tamanho Corporal , Tardígrados/fisiologia , Animais , Evolução Biológica , Miniaturização , Fenótipo
2.
J Chromatogr A ; 1626: 461374, 2020 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-32797852

RESUMO

This work demonstrates the development of a compact, modular, cost-effective separation system configured to address a specific separation problem. The principles of the separation are based on gradient capillary liquid chromatography where the system consists of precision stepper motor-driven portable syringe pumps with interchangeable glass syringes (100 µL to 1000 µL). Excellent flow-rate precision of < 1% RSD was achieved with typical flow-rates ranging from 1 µL/min to 100 µL/min, which was ideal for capillary columns. A variable external loop volume and electrically actuated miniature injection valve was used for sample introduction. Detection was based upon a commercial Z-type UV absorbance flow-cell housed within a custom-built cooling enclosure (40 mm x 40 mm) which also contained a UV-LED light-source and a photodiode. System and chromatographic performance was evaluated using linear gradient elution, with day to day repeatability of <1.5% RSD (n = 6) for peak area, and < 0.4% RSD (n = 6) for retention time, for the separation of a 5 component mixture using a 50 mm X 530 µm ID C18 3 µm particle capillary column. The system can run any commercial or in-house packed columns from 50 mm to 100 mm length with IDs ranging from 200 to 700 µm. The developed portable system was operated using custom-built windows-based chromatography software, complete with data acquisition and system control.


Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Cafeína/análise , Carbamazepina/análise , Análise Custo-Benefício , Limite de Detecção , Miniaturização , Sistemas Automatizados de Assistência Junto ao Leito , Reprodutibilidade dos Testes , Espectrofotometria Ultravioleta , Sulfametazina/análise
3.
J Chromatogr A ; 1627: 461433, 2020 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-32823090

RESUMO

Atmospheric particulate matter (PM) is made up of suspended microscopic solid or liquid materials. It is derived from natural or anthropogenic sources. PM encompasses inhalable coarse particles, with aerodynamic diameters of between 2.5 µm and 10 µm, fine particles (<2.5 µm), and ultrafine (<0.1 µm) particles. In addition to being directly inhalable, causing harm, PM can also exert adverse effects on human wellbeing and the environment by its impact on precipitation and climate. Moreover, chemical contaminants may also be found adsorbed on PM, adding another dimension to the hazardous aspects of these materials. PM is normally collected on filters or impactors. PM-adsorbed contaminants need to be taken into solution before they can be extracted. This review focuses on a discussion of solvent-minimized sample preparation procedures, originally developed for aqueous samples, for the extraction and preconcentration of primarily organic contaminants from fine and coarse PM.


Assuntos
Poluentes Atmosféricos/análise , Atmosfera/química , Material Particulado/análise , Adsorção , Humanos , Miniaturização
4.
Lab Chip ; 20(19): 3560-3568, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-32844858

RESUMO

A miniaturized polymerase chain reaction (PCR) system is not only important for medical applications in remote areas of developing countries, but also important for testing at ports of entry during global epidemics, such as the current outbreak of the coronavirus. Although there is a large number of PCR sensor systems available for this purpose, there is still a lack of portable digital PCR (dPCR) heating systems. Here, we first demonstrated a portable plasmonic heating-based dPCR system. The device has total dimensions of 9.7 × 5.6 × 4.1 cm and a total power consumption of 4.5 W, allowing for up to 25 dPCR experiments to be conducted on a single charge of a 20 000 mAh external battery. The dPCR system has a maximum heating rate of 10.7 °C s-1 and maximum cooling rate of 8 °C s-1. Target DNA concentrations in the range from 101 ± 1.4 copies per µL to 260 000 ± 20 000 copies per µL could be detected using a poly(dimethylsiloxane) (PDMS) microwell membrane with 22 080 well arrays (20 µm diameter). Furthermore, the heating system was demonstrated using a mass producible poly(methyl methacrylate) PMMA microwell array with 8100 microwell arrays (80 µm diameter). The PMMA microwell array could detect a concentration from 12 ± 0.7 copies per µL to 25 889 ± 737 copies per µL.


Assuntos
Reação em Cadeia da Polimerase/instrumentação , Algoritmos , Técnicas Biossensoriais , DNA/química , Fontes de Energia Elétrica , Humanos , Membranas Artificiais , Miniaturização , Polimetil Metacrilato
5.
J Chromatogr A ; 1624: 461241, 2020 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-32540079

RESUMO

Synthetic opioids are responsible for numerous overdoses and fatalities worldwide. Currently, fentanyl and its analogs are also mixed with heroin, cocaine and methamphetamine, or sold as oxycodone, hydrocodone and alprazolam in counterfeit medications. Microextraction techniques became more frequent in analytical toxicology over the last decade. A method to simultaneously quantify nine synthetic opioids, fentanyl, sufentanil, alfentanil, acrylfentanyl, thiofentanyl, valerylfentanyl, furanylfentanyl, acetyl fentanyl and carfentanil, and two metabolites, norfentanyl and acetyl norfentanyl, in urine samples by microextraction with packed sorbent (MEPS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed and validated. A multivariate optimization was performed to establish the number and speed (stroke) of draw-eject sample cycles and the extraction solvent. The best extraction condition was eight draw-eject sample cycles, with a velocity of 3.6 µL/sec and acetonitrile as elution solvent. Linearity was achieved between 1 to 100 ng/mL, with a limit of detection (LOD) of 0.1 ng/mL and limit of quantification (LOQ) of 1 ng/mL. Imprecision (% relative standard deviation) and bias (%) were less than 12.8% and 5.7%, respectively. The method had good specificity and selectivity when challenged with 10 different matrix sources and 36 pharmaceuticals and drugs of abuse at concentrations of 100 or 500 ng/mL. The method was successfully applied to authentic urine samples. MEPS was an efficient semi-automatic extraction technique, requiring small volumes of organic solvents (640 µL) and sample (200 µL). The cartridges can be cleaned and reused (average of 150 sample extractions/barrel inside and needle).


Assuntos
Analgésicos Opioides/urina , Cromatografia Líquida/métodos , Miniaturização/métodos , Microextração em Fase Sólida/métodos , Espectrometria de Massas em Tandem/métodos , Analgésicos Opioides/química , Cromatografia Líquida de Alta Pressão/métodos , Fentanila/urina , Humanos , Limite de Detecção , Solventes/química
6.
PLoS One ; 15(6): e0233340, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32492038

RESUMO

The miniaturization of stone tools, as reflected through the systematic production of bladelets and bladelet tools (microliths), characterized many industries of the Late Pleistocene, with the Levantine Epipalaeolithic serving as a well-studied example. It is commonly held that microliths were used as modular inserts in composite projectiles, while their incorporation in other tools for different tasks is generally overlooked, the latter aspect being the main focus of this paper. We present here a more inclusive approach through a case study of the Geometric Kebaran (Middle Epipalaeolithic, ca. 18,500-15,000 cal BP) site of Neve David, Mount Carmel, Israel. Recent excavations at the site exposed a variety of features, and one well-preserved shallow pit provided a large lithic assemblage with ca. 90 microliths. We studied this assemblage using both the low- and high- magnification use-wear protocols, accompanied by a range of experiments. Our results show that a) the fragmentation rate is very high in this assemblage (ca. 90%), b) most of the microliths have identifiable use-wear, c) the microliths were commonly used as inserts in composite projectiles, d) many microliths were used for functions not related to weaponry and hunting, such as wood-working, weed harvesting and meat processing. These findings strongly support the suggestion that the small insets, regardless of their specific type (trapeze, rectangle, backed/retouched bladelet), were used in a wide variety of composite tools. We argue that such a versatile approach and flexibility in the use of microliths reflect a technological advantage where a minimal set of microlithic types, produced in large numbers, could provide the required elements for weapons, as well as for a variety of cutting, processing and harvesting tools needed for mundane tasks at a large Middle Epipalaeolithic camp.


Assuntos
Armas/história , Arqueologia , Desenho de Equipamento/história , Fenômenos Geológicos , História Antiga , Humanos , Indústrias/história , Israel , Miniaturização , Tecnologia/história
7.
PLoS One ; 15(5): e0232315, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32365071

RESUMO

The INTRABEAM Carl Zeiss Surgical system (Oberkochen, Germany) is a miniature accelerator producing low energy photons (50 keV maximum). The published dosimetric characterization of the INTRABEAM was based on detectors (radiochromic films or ionization chambers) not allowing measuring the absorbed dose in the first millimeters of the irradiated medium, where the dose is actually prescribed. This study aims at determining with Magnetic Resonance Imaging (MRI) the sensitivity of a paramagnetic gel in order to measure the dose deposit produced with the INTRABEAM from 0 to 20 mm. Although spherical applicators are mostly used with the INTRABEAM system for breast applications, this study focuses on surface applicators that are of interest for cutaneous carcinomas. The irradiations at 12 different dose levels (between 2 Gy and 50 Gy at the gel surface) were performed with the INTRABEAM and a 4 cm surface applicator. The gel used in this study is a new « sensitive ¼ material. In order to compare gel sensitivity at low energy with high energy, gels were irradiated by an 18 MV photon beam produced by a Varian Clinac 2100 CD. T2 weighted multi echo MRI sequences were performed with 16 echo times. The T2 signal versus echo times was fitted with a mono-exponential function with 95% confidence interval. The calibration curve determined at low energy is a linear function (r2 = 0.9893) with a sensitivity of 0.0381 s-1.Gy-1, a similar linear function was obtained at high energy (0.0372 s-1.Gy-1 with r2 = 0.9662). The calibration curve at low energy was used to draw isodose maps from the MR images. The PDD (Percent Depth Dose) determined in the gel is within 5%-1mm of the ionization chamber PDD except for one point. The dosimetric sensitivity of this new paramagnetic ferrous gel was determined with MRI measurements. It allowed measuring the dose distribution specifically in the first millimeters for an irradiation with the INTRABEAM miniature accelerator equipped with a surface applicator.


Assuntos
Compostos Ferrosos/química , Radiometria/instrumentação , Géis , Fenômenos Magnéticos , Miniaturização , Aceleradores de Partículas , Doses de Radiação , Razão Sinal-Ruído , Raios X
8.
Adv Exp Med Biol ; 1230: 121-135, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32285368

RESUMO

Microfluidic devices are now one of the most promising tools to mimic in vivo like conditions, either in normal or disease scenarios, such as tumorigenesis or pathogenesis. Together with the potential of biomaterials, its combination with microfluidics represents the ability to more closely mimic cells' natural microenvironment concerning its three-dimensional (3D) nature and continuous perfusion with nutrients and cells' crosstalk. Due to miniaturization and increased experimental throughput, microfluidics have generated significant interest in the drug discovery and development domain. Herein, the most recent advances in the field of microfluidics for drug discovery are overviewed, and the role of biomaterials in 3D in vitro models and the contribution of organ-on-a-chip technologies highlighted.


Assuntos
Materiais Biocompatíveis , Desenvolvimento de Medicamentos , Descoberta de Drogas , Dispositivos Lab-On-A-Chip , Microfluídica , Humanos , Miniaturização
11.
PLoS One ; 15(3): e0230348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32182279

RESUMO

Before Europeans arrived to Eastern North America, prehistoric, indigenous peoples experienced a number of changes that culminated in the development of sedentary, maize agricultural lifeways of varying complexity. Inherent to these lifeways were several triggers of social stress including population nucleation and increase, intergroup conflict (warfare), and increased territoriality. Here, we examine whether this period of social stress co-varied with deadlier weaponry, specifically, the design of the most commonly found prehistoric archery component in late pre-contact North America: triangular stone arrow tips (TSAT). The examination of modern metal or carbon projectiles, arrows, and arrowheads has demonstrated that smaller arrow tips penetrate deeper into a target than do larger ones. We first experimentally confirm that this relationship applies to arrow tips made from stone hafted onto shafts made from wood. We then statistically assess a large sample (n = 742) of late pre-contact TSAT and show that these specimens are extraordinarily small. Thus, by miniaturizing their arrow tips, prehistoric people in Eastern North America optimized their projectile weaponry for maximum penetration and killing power in warfare and hunting. Finally, we verify that these functional advantages were selected across environmental and cultural boundaries. Thus, while we cannot and should not rule out stochastic, production economizing, or non-adaptive cultural processes as an explanation for TSAT, overall our results are consistent with the hypothesis that broad, socially stressful demographic changes in late pre-contact Eastern North America resulted in the miniaturization-and augmented lethality-of stone tools across the region.


Assuntos
Índios Norte-Americanos/história , Miniaturização , Fatores Sociológicos , Guerra/história , Armas/história , Arqueologia , História Antiga , Humanos , Índios Norte-Americanos/psicologia , América do Norte , Crescimento Demográfico , Guerra/psicologia
12.
Expert Rev Med Devices ; 17(4): 323-330, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32118488

RESUMO

Introduction: The global heart failure (HF) burden is expected to increase due to aging populations, increasing number of end-stage HF patients and adverse lifestyle changes. Mechanical circulatory support (MCS) devices such as left ventricular assist devices (LVADs) have become a promising treatment option for short-term and long-term circulatory support of end-stage HF patients.Areas covered: Recent developments in MCS technology have been focused on miniaturization leading to the development of minimally invasive surgical procedures for LVAD implantation. This helps overcome possible postoperative complications such as major incisions and poor outcomes due to infections, right heart failure, and bleeding. This article discusses clinical and technological developments in the field of minimally invasive procedures for LVAD implantation.Expert opinion: Most patients might benefit from minimally invasive LVAD implantation performed through a limited left lateral thoracotomy associated with an upper hemisternotomy or a right anterior thoracotomy. The thoracotomy approach can also be considered in case of pump exchange or pump explant. The success of these techniques is mainly based on the optimization of LVAD pump design, inflow cannula insertion, and outflow graft as well as driveline exit sites. The future direction of the LVAD field is likely to include less-invasive approaches and smartificial technologies.


Assuntos
Coração Auxiliar , Procedimentos Cirúrgicos Minimamente Invasivos , Desenho de Prótese , Implantação de Prótese , Ensaios Clínicos como Assunto , Humanos , Miniaturização
13.
J Chromatogr A ; 1620: 461009, 2020 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-32173027

RESUMO

A fast method for analysis of 47 pharmaceuticals active compounds (PhACs) in fish muscle has been developed and validated addressing the parameters accuracy, precision (intraday and interday), matrix effect at three spiking levels: 5, 25 and 50 ng PhAC g-1 in fish as well as linearity, limit of detection (LOD), limit of quantification (LOQ). Sixteen protocols were performed varying extraction techniques, solvents, sample filtration and clean-up step. The selected method was based on an ultrasound extraction with acidified mixture of acetonitrile and isopropyl alcohol followed by a clean-up step using Z-Sep/C18 sorbents. Quantitative analysis of the PhACs in the extracts was accomplished by UPLC- QTOF-MS using Sequential Window Acquisition of All Theoretical Fragment-Ion, SWATHTM acquisition technology. 90% Of the compounds presented extraction recoveries between 60 and 130% with LOQ between 0.2 and 11 ng g-1. The validated method was applied to the analysis of 32 muscle samples from thirteen different species of fish collected in four European river basins (Adige, Evrotas, Llobregat and Sava). A total of ten compounds were found in fish samples with diltiazem as the most frequently detected one followed by carbamazepine and caffeine. Additionally, by taking advantage of the information-rich mass spectral data from the SWATH mode acquisition, the raw data were reprocessed for the presence of the most prescribed 250 pharmaceuticals, metabolites, and drugs of abuse previously reported to occur in the aquatic environment. By considering the mass errors of the molecular ion (˂± 3 ppm) and one characteristic fragment ion (˂±10 ppm) as well as the Library score and the Formula Finder score of the data processing software six compounds were retrieved, and eventually four of them confirmed with authentic standards: cocaine and its metabolite benzoylecgonine, the stimulant nicotine, and the antibiotic ofloxacin. Two lipid regulators, lovastatin and simvastatin, were determined as a false positive.


Assuntos
Monitoramento Ambiental , Peixes/metabolismo , Miniaturização/métodos , Preparações Farmacêuticas/análise , Rios , Animais , Cromatografia Líquida/métodos , Íons , Limite de Detecção , Reprodutibilidade dos Testes
14.
J Vasc Access ; 21(2): 241-245, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32174238

RESUMO

Central venous catheterization of children is often a challenging procedure due to small anatomical structures. Ultrasound guidance has been shown to reduce complications and improve cannulation success as compared with the landmark-based technique. In-plane techniques allow for longitudinal visualization of the vessels and real-time visualization of needle track during its advancement. When in-plane and syringe-free techniques are combined, advancement of the guidewire can also be visualized. We aim to introduce our supraclavicular approach for brachiocephalic vein cannulation in pediatric patients. A syringe-free and in-plane technique is used to cannulate the patients. The subclavian, jugular, and the brachiocephalic veins were visualized by endocavity micro-convex ultrasound probe as a Y shape during the cannulation procedure. We present a case series of successful cannulation by using this technique.


Assuntos
Veias Braquiocefálicas/diagnóstico por imagem , Cateterismo Venoso Central/instrumentação , Cateterismo Periférico/instrumentação , Ultrassonografia de Intervenção/instrumentação , Extremidade Superior/irrigação sanguínea , Dispositivos de Acesso Vascular , Cateterismo Venoso Central/efeitos adversos , Cateterismo Periférico/efeitos adversos , Pré-Escolar , Desenho de Equipamento , Humanos , Lactente , Miniaturização , Punções , Ultrassonografia de Intervenção/efeitos adversos
15.
Food Chem ; 317: 126437, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32109660

RESUMO

SO2 is a type of additive widely used in the food processing industry as preservative and anti-browning, bleaching, or effective antibacterial agent. However, the SO2 residue can have adverse effects on human health. In this work, a low-temperature microplasma generated by dielectric barrier discharge was used for the direct, in situ excitation of the molecular emission of SO2 in food samples. The food samples were acidified and heated to release SO2 and a miniaturized charge-coupled device spectrometer recorded the characteristic emission line at 301.9 nm. The linear correlation coefficient of the method was greater than 0.99 in the range of 10 to 100 mg L-1. Moreover, the limit of detection was 0.01 mg L-1, with recoveries between 72% and 108% and relative standard deviations of 1.5%-7.6%. The method is simple, accurate, low-cost, involves miniaturized and compact equipment and is suitable for the determination of total SO2 in food samples.


Assuntos
Análise de Alimentos/instrumentação , Espectrofotometria Atômica/instrumentação , Dióxido de Enxofre/análise , Desenho de Equipamento , Aditivos Alimentares/análise , Análise de Alimentos/métodos , Limite de Detecção , Miniaturização , Espectrofotometria Atômica/métodos
16.
Talanta ; 211: 120672, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32070595

RESUMO

Cannabinoids in hemp plant are strictly located in the inflorescence, in particular in top side of the plant while a lower amount may be found in the leaves. As a consequence, the lower amount of cannabinoids which can be recovered in the hemp flours is obtained from seeds, thus from contamination during harvesting procedures. To this aim, a screening test for the real time detection of cannabinoids in hemp flour was developed by a miniaturized analytical platform based on the MicroNIR spectrometer. Chemometrics was used to develop models of prediction to identify the cannabinoids and simultaneously to quantify the residual amounts in order to accomplish specific regulatory legislation according to the country. In particular, Partial Least Square-Discriminant Analysis (PLS-DA) and Partial Least Square regression (PLSr) were applied and results demonstrated that MicroNIR/Chemometric platform permit to differentiate hemp flours according to the presence of CBD, THC and CBG. In addition, for each cannabinoid, a quantification method was developed in the range 0.001-0.1 %ww, and their performances were evaluated by comparing results to those obtained by the reference procedures. Processing of the real samples provided a suitable correlation and confirmed the capabilities of this innovative platform to be used for the monitoring of the residual content of cannabinoids in hemp flours.


Assuntos
Canabinoides/análise , Farinha/análise , Cannabis , Contaminação de Alimentos/análise , Miniaturização , Espectroscopia de Luz Próxima ao Infravermelho
17.
Nucleic Acids Res ; 48(7): e37, 2020 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-32025730

RESUMO

The development of complex methods in molecular biology is a laborious, costly, iterative and often intuition-bound process where optima are sought in a multidimensional parameter space through step-by-step optimizations. The difficulty of miniaturizing reactions under the microliter volumes usually handled in multiwell plates by robots, plus the cost of the experiments, limit the number of parameters and the dynamic ranges that can be explored. Nevertheless, because of non-linearities of the response of biochemical systems to their reagent concentrations, broad dynamic ranges are necessary. Here we use a high-performance nanoliter handling platform and computer generation of liquid transfer programs to explore in quadruplicates 648 combinations of 4 parameters of a biochemical reaction, the reverse-transcription, which lead us to uncover non-linear responses, parameter interactions and novel mechanistic insights. With the increased availability of computer-driven laboratory platforms for biotechnology, our results demonstrate the feasibility and advantage of methods development based on reproducible, computer-aided exhaustive characterization of biochemical systems.


Assuntos
Fenômenos Bioquímicos , Transcrição Reversa , Animais , Automação Laboratorial , Células HeLa , Humanos , Camundongos , Miniaturização , Reação em Cadeia da Polimerase , Análise de Célula Única
18.
Ann Thorac Surg ; 110(2): e99-e101, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32006477

RESUMO

Bronchial stenosis after chest surgery is a rare event. In upper lobectomy it is likely due to the upward movement of the remaining lobes with torsion of the bronchus and edema. This case report describes the use of existing tools and prosthesis to create a novel miniature Y stent for a stenotic lobar bronchus that rapidly bifurcates, not allowing the insertion of a standard bronchial stent.


Assuntos
Broncopatias/cirurgia , Complicações Pós-Operatórias/cirurgia , Stents , Constrição Patológica/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Miniaturização , Desenho de Prótese
20.
Vascular ; 28(4): 436-440, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32089108

RESUMO

Level one trauma centers experience horrific injuries on a regular basis. Blunt or penetrating trauma causing vascular injuries are treated by surgeons and interventional radiologists. When a blood vessel is completely transected, the ends of the vessel retract and vasospasm occurs as a normal survival response. When this phenomenon occurs, it is sometimes impossible to reattach the two ends of the injured vessel by surgical means and a bypass graft is often required. However, from an endovascular perspective, covered stents can serve as a vascular bypass as well. The limiting factor with an endovascular approach is the ability to successfully gain wire access across the injured vessel. The technique described in this manuscript describes a "rendezvous" method of repairing a transected axillosubclavian artery from a high-speed motorcycle accident using a steerable microcatheter. Initially, multiple failed attempts to cross the injured vessel were encountered despite using a wide variety of conventional guidewires and catheters. A steerable microcatheter was then used to safely and effectively navigate more than 15 cm through soft tissue to the opposite end of the vessel. In this critically ill patient, this technique significantly reduced the procedural time when compared to our previous experiences repairing arterial transections using traditional catheters.


Assuntos
Implante de Prótese Vascular/métodos , Procedimentos Endovasculares/métodos , Artéria Subclávia/cirurgia , Lesões do Sistema Vascular/cirurgia , Vasoconstrição , Acidentes de Trânsito , Adulto , Implante de Prótese Vascular/instrumentação , Procedimentos Endovasculares/instrumentação , Humanos , Masculino , Miniaturização , Motocicletas , Duração da Cirurgia , Stents , Artéria Subclávia/diagnóstico por imagem , Artéria Subclávia/lesões , Artéria Subclávia/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Dispositivos de Acesso Vascular , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/fisiopatologia
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