Determination of optimal implantation site in central venous system for wireless hemodynamic monitoring

Manavi, Tejaswini; Vázquez, Patricia; Tubassam, Muhammad; Zafar, Junaid; Sharif, Faisal; Zafar, Haroon

doi:10.1016/j.ijcha.2020.100510

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…IVC is considered as an optimal site for implantation since it presents a straight tube and provides a relatively easy access point when compared with the superior veins [ 44 ]. According to a previous study conducted by Manavi et al, a location midway between the renal veins and iliac bifurcation serves as a potential site for implantation of a haemodynamic sensor [ 44 ]. This long straight portion of the vessel has a potential for good anchorage as compared with the branched vessels in the superior vena cava.…”

Section: Methodsmentioning

confidence: 99%

Design and Haemodynamic Analysis of a Novel Anchoring System for Central Venous Pressure Measurement

Manavi

Ijaz

O’Grady

et al. 2022

Sensors

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Background/Objective: In recent years, treatment of heart failure patients has proved to benefit from implantation of pressure sensors in the pulmonary artery (PA). While longitudinal measurement of PA pressure profoundly improves a clinician’s ability to manage HF, the full potential of central venous pressure as a clinical tool has yet to be unlocked. Central venous pressure serves as a surrogate for the right atrial pressure, and thus could potentially predict a wider range of heart failure conditions. However, it is unclear if current sensor anchoring methods, designed for the PA, are suitable to hold pressure sensors safely in the inferior vena cava. The purpose of this study was to design an anchoring system for accurate apposition in inferior vena cava and evaluate whether it is a potential site for central venous pressure measurement. Materials and Methods: A location inferior to the renal veins was selected as an optimal site based on a CT scan analysis. Three anchor designs, a 10-strut anchor, and 5-struts with and without loops, were tested on a custom-made silicone bench model of Vena Cava targeting the infra-renal vena cava. The model was connected to a pulsatile pump system and a heated water bath that constituted an in-vitro simulation unit. Delivery of the inferior vena cava implant was accomplished using a preloaded introducer and a dilator as a push rod to deploy the device at the target area. The anchors were subjected to manual compression tests to evaluate their stability against dislodgement. Computational Fluid Dynamics (CFD) analysis was completed to characterize blood flow in the anchor’s environment using pressure-based transient solver. Any potential recirculation zones or disturbances in the blood flow caused by the struts were identified. Results: We demonstrated successful anchorage and deployment of the 10-strut anchor in the Vena Cava bench model. The 10-strut anchor remained stable during several compression attempts as compared with the other two 5-strut anchor designs. The 10-strut design provided the maximum number of contact points with the vessel in a circular layout and was less susceptible to movement or dislodgement during compression tests. Furthermore, the CFD simulation provided haemodynamic analysis of the optimum 10-strut anchor design. Conclusions: This study successfully demonstrated the design and deployment of an inferior vena cava anchoring system in a bench test model. The 10-strut anchor is an optimal design as compared with the two other 5-strut designs; however, substantial in-vivo experiments are required to validate the safety and accuracy of such implants. The CFD simulation enabled better understanding of the haemodynamic parameters and any disturbances in the blood flow due to the presence of the anchor. The ability to place a sensor technology in the vena cava could provide a simple and minimally invasive approach for heart failure patients.

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Section: Methodsmentioning

confidence: 99%

Design and Haemodynamic Analysis of a Novel Anchoring System for Central Venous Pressure Measurement

Manavi

Ijaz

O’Grady

et al. 2022

Sensors

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“…[ 53 , 75 ]. Future HF monitoring systems rely on venous sensing to track systemic congestion and detect changes in intravascular volume through real-time monitoring of CVP and IVC area [ 72 , 73 , 76 , 77 ].…”

Section: Sensor-based Hf Monitoringmentioning

confidence: 99%

“…The preference for device implantation in a compliant vessel such as IVC has been outlined in a study involving a CT scan analysis to study the difference in IVC diameters in a group of patients with peripheral vascular disease (PVD) [ 77 ]. In addition, a study by Manavi et al demonstrated the safety and efficacy of a novel IVC sensor ( Figure 7 a) for wireless measurement of CVP in an acute animal study.…”

Section: Sensor-based Hf Monitoringmentioning

confidence: 99%

An Era of Digital Healthcare—A Comprehensive Review of Sensor Technologies and Telehealth Advancements in Chronic Heart Failure Management

Manavi,

Zafar,

Sharif

2024

Sensors

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Heart failure (HF) is a multi-faceted, complex clinical syndrome characterized by significant morbidity, high mortality rate, reduced quality of life, and rapidly increasing healthcare costs. A larger proportion of these costs comprise both ambulatory and emergency department visits, as well as hospital admissions. Despite the methods used by telehealth (TH) to improve self-care and quality of life, patient outcomes remain poor. HF management is associated with numerous challenges, such as conflicting evidence from clinical trials, heterogeneity of TH devices, variability in patient inclusion and exclusion criteria, and discrepancies between healthcare systems. A growing body of evidence suggests there is an unmet need for increased individualization of in-hospital management, continuous remote monitoring of patients pre and post-hospital admission, and continuation of treatment post-discharge in order to reduce re-hospitalizations and improve long-term outcomes. This review summarizes the current state-of-the-art for HF and associated novel technologies and advancements in the most frequently used types of TH (implantable sensors), categorizing devices in their preclinical and clinical stage, bench-to-bedside implementation challenges, and future perspectives on remote HF management to improve long-term outcomes of HF patients. The Review also highlights recent advancements in non-invasive remote monitoring technologies demonstrated by a few pilot observational prospective cohort studies.

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“…The SSP is measured at the stairs object within the phantom. The thickness of the stairs object is usually obtained using the caliper on the console [16].…”

mentioning

confidence: 99%

An evaluation of automated measurement of slice sensitivity profile of computed tomography image: field of view variations

Widyanti

Anam²,

Hidayanto³

et al. 2023

IJEECS

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This study aims to evaluate the automated measurement of slice sensitivity profile (SSP) on the American Association of Physicists in Medicine (AAPM) computed tomography (CT) performance phantom for variations of slice thickness and field of view (FOV). The AAPM CT performance phantom was scanned using a Philips MRC 880 CT Scanner for variations of slice thickness and FOV. The slice thickness values were 1, 3, and 5 mm. The FOV values were 240, 300, 340, 400, and 440 mm. The automated SSPs and their fullwidth at half maximums (FWHMs) were automatically measured from the middle stair object of the phantom. To validate the automated measurement results, the FWHM values of SSPs obtained were compared to those from manual measurements. The differences between FWHMs from automated measurements and set slice thicknesses are less than 0.3 mm, while the differences between FWHMs from automated and manual measurements are less than 0.2 mm. The results from automated measurements are closer to the set slice thickness than those from manual measurements. This automated SSP measurement provides high accuracy and precision for both the slice thickness and the FOV variations.

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Determination of optimal implantation site in central venous system for wireless hemodynamic monitoring

Cited by 3 publications

References 14 publications

Design and Haemodynamic Analysis of a Novel Anchoring System for Central Venous Pressure Measurement

Design and Haemodynamic Analysis of a Novel Anchoring System for Central Venous Pressure Measurement

An Era of Digital Healthcare—A Comprehensive Review of Sensor Technologies and Telehealth Advancements in Chronic Heart Failure Management

An evaluation of automated measurement of slice sensitivity profile of computed tomography image: field of view variations

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