Expert review of medical devices最新文献_第2页

Expandable cage technology in minimally invasive transforaminal interbody fusion: where are we and what does the future hold?

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-12 DOI: 10.1080/17434440.2025.2477610

Chibuikem A Ikwuegbuenyi, Noah Willett, Evan Wang, Sean Inzerillo, Ibrahim Hussain

{"title":"Expandable cage technology in minimally invasive transforaminal interbody fusion: where are we and what does the future hold?","authors":"Chibuikem A Ikwuegbuenyi, Noah Willett, Evan Wang, Sean Inzerillo, Ibrahim Hussain","doi":"10.1080/17434440.2025.2477610","DOIUrl":"10.1080/17434440.2025.2477610","url":null,"abstract":"Introduction: Expandable cages are designed to address the limitations of static cages in minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). These devices enable collapsed insertion with in-situ expansion, aiming to restore disc height and lordosis, indirect foraminal decompression, and sagittal alignment with reduced neural and tissue trauma. Advancements in bi-dimensional cage expansion, endplate interaction, and innovative materials have been designed in attempt to improve fusion rates and clinicoradiographic outcomes.Areas covered: This review examines the structural design and mechanisms of expandable interbody cages, their clinical outcomes compared to static cages, and their limitations, including subsidence and cost. PubMed, Scopus, and Google Scholar were reviewed for relevant literature published up until November, 2024. We also discuss emerging technologies, such as bi-planar expansion cage technology and patient-specific implants, and their potential to optimize fusion procedures.Expert opinion: Expandable cages offer clear benefits for MI-TLIF, mainly restoring disc height and minimizing insertion-related risks. Innovations like bi-planar and patient-specific designs help address limitations, but cost and long-term outcomes remain concerns. These devices can improve fusion outcomes, especially in degenerative or deformity cases.","PeriodicalId":94006,"journal":{"name":"Expert review of medical devices","volume":" ","pages":"349-360"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An overview of utilizing artificial intelligence in localized prostate cancer imaging.

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-19 DOI: 10.1080/17434440.2025.2477601

Emma Stevenson, Omer Tarik Esengur, Haoyue Zhang, Benjamin D Simon, Stephanie A Harmon, Baris Turkbey

{"title":"An overview of utilizing artificial intelligence in localized prostate cancer imaging.","authors":"Emma Stevenson, Omer Tarik Esengur, Haoyue Zhang, Benjamin D Simon, Stephanie A Harmon, Baris Turkbey","doi":"10.1080/17434440.2025.2477601","DOIUrl":"10.1080/17434440.2025.2477601","url":null,"abstract":"Introduction: Prostate cancer (PCa) is a leading cause of cancer-related deaths among men, and accurate diagnosis is critical for effective management. Multiparametric MRI (mpMRI) has become an essential tool in PCa diagnosis due to its superior spatial resolution which enables detailed anatomical, functional information and its resultant ability to detect clinically significant PCa. However, challenges such as subjective interpretation methods and high inter-reader variability remain. In recent years, artificial intelligence (AI) has emerged as a promising solution to enhance the diagnostic performance of mpMRI by automating key tasks such as prostate segmentation, lesion detection, classification.Areas covered: This review provides a comprehensive overview of the current AI applications in prostate mpMRI, discussing advancements in automated image analysis and how AI-driven models are developed to improve detection and risk stratification. A literature search was conducted to examine both machine learning and deep learning techniques applied in this field, highlighting key studies and future directions.Expert opinion: While AI models have shown significant promise, their clinical integration remains limited due to the need for larger, multi-institutional validation studies. As AI continues to evolve, multimodal approaches combining imaging with clinical data are likely to play pivotal role in personalized PCa diagnosis, treatment planning.","PeriodicalId":94006,"journal":{"name":"Expert review of medical devices","volume":" ","pages":"293-310"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of LMA gastro airway versus endotracheal tube for therapeutic endoscopic retrograde cholangiopancreatography under general anesthesia: a randomized trial.

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-20 DOI: 10.1080/17434440.2025.2479805

Anju Gupta, Pramod Kumar Garg, Rajeshwari Subramanium, Shalimar Shalimar, Deepak Gunjan, Soumya Jagannath, Karthik V Iyer, Rajeev Kumar Malhotra

{"title":"Efficacy of LMA gastro airway versus endotracheal tube for therapeutic endoscopic retrograde cholangiopancreatography under general anesthesia: a randomized trial.","authors":"Anju Gupta, Pramod Kumar Garg, Rajeshwari Subramanium, Shalimar Shalimar, Deepak Gunjan, Soumya Jagannath, Karthik V Iyer, Rajeev Kumar Malhotra","doi":"10.1080/17434440.2025.2479805","DOIUrl":"10.1080/17434440.2025.2479805","url":null,"abstract":"Objectives: LMA Gastro Airway (LGA) is an advanced airway device that allows simultaneous endoscopy and ventilation during endoscopic retrograde cholangiopancreatography (ERCP). It can be an alternative to an endotracheal tube (ETT) and hasten recovery from general anesthesia (GA). We aimed to compare LGA with ETT regarding recovery from anesthesia and adverse respiratory events.Methods: In this randomized controlled trial, 60 adult patients undergoing ERCP under GA were included. The airway was secured with an ETT (Group A, n = 30) or LGA (Group B, n = 30). The primary outcomes were the emergence time and adverse respiratory events.Results: LGA and ETT effectively maintained ventilation with comparable respiratory adverse events. The success rate of insertion of LGA was high (92%), and the insertion time [median (IQR)] of LGA was significantly shorter [37 s (28-56) vs 14.5 s (11-21)] (p < 0.001). The emergence [8(6.0-13.3) vs. 3 (3-5)] and total recovery time [20.5(14.75-30) vs. 12.5 (8.8-19)] was considerably shorter with LMA Gastro, with similar postoperative complications. The endoscopic satisfaction [3 (2-3) vs. 2 (1-3), p < 0.001] was better in the ETT group.Conclusion: LGA provides faster recovery times with a similar safety profile to ETT. It is a suitable alternative to ETT for patients undergoing ERCP.Trial registration: CTRI/2020/08/027268; Principal Investigator: Dr Anju Gupta, Date of registration: 20 August 2020.","PeriodicalId":94006,"journal":{"name":"Expert review of medical devices","volume":" ","pages":"387-395"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pulsed field ablation for atrial fibrillation.

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI: 10.1080/17434440.2025.2475239

Vedran Pašara, Tommaso Sattin, Carlo De Asmundis, Gian-Battista Chierchia, Gezim Bala

{"title":"Pulsed field ablation for atrial fibrillation.","authors":"Vedran Pašara, Tommaso Sattin, Carlo De Asmundis, Gian-Battista Chierchia, Gezim Bala","doi":"10.1080/17434440.2025.2475239","DOIUrl":"10.1080/17434440.2025.2475239","url":null,"abstract":"Introduction: Atrial fibrillation is the most common sustained arrhythmia, associated with substantial morbidity and a reduced quality of life. The current standard of care, transcatheter pulmonary vein isolation using thermal ablation techniques, provides symptom relief but carries a risk of collateral tissue damage. In recent years, pulsed field ablation, a nonthermal technique based on irreversible electroporation, has emerged as a promising alternative to conventional thermal ablation methods.Areas covered: This review provides an overview of pulsed field ablation, a novel nonthermal ablation technique. We briefly explain its biophysical principles and general technical aspects, describe currently available technologies, and summarize findings from clinical studies. Additionally, we discuss its safety profile, unresolved issues, and limitations, while also exploring future perspectives.Expert opinion: Pulsed field ablation offers distinct advantages over traditional thermal ablation methods, such as shorter procedure times and a favorable safety profile due to precise tissue targeting. Future improvements in ablation device design, energy delivery settings, integration with mapping systems, workflow efficiency, ablation protocols, and patient selection criteria are expected to further enhance clinical outcomes.","PeriodicalId":94006,"journal":{"name":"Expert review of medical devices","volume":" ","pages":"311-320"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New insights of the adaptation of flow diverters to the local geometry of vessel in the treatment of intracranial aneurysms.

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-20 DOI: 10.1080/17434440.2025.2478247

Arià Jaimejuan, Santiago Estevez-Areco, Laura Obradó, Hector Fernandez, Jordi Blasco, Luis San Román, Juan M Macho, Demetrius Lopes, Carlos Castaño, Sebastian Remollo, Ignacio Larrabide

{"title":"New insights of the adaptation of flow diverters to the local geometry of vessel in the treatment of intracranial aneurysms.","authors":"Arià Jaimejuan, Santiago Estevez-Areco, Laura Obradó, Hector Fernandez, Jordi Blasco, Luis San Román, Juan M Macho, Demetrius Lopes, Carlos Castaño, Sebastian Remollo, Ignacio Larrabide","doi":"10.1080/17434440.2025.2478247","DOIUrl":"10.1080/17434440.2025.2478247","url":null,"abstract":"Purpose: It is unclear how flow diverters (FDs) and vessels interact in the treatment of intracranial aneurysms. In this study, we examine the local changes in artery and device morphology caused by their mutual interaction.Methods: Pre-treatment 3DRA and post-treatment XperCT or DynaCT images were collected retrospectively from 25 patients. Vessel anatomies and FD models were obtained by segmenting the corresponding images. Perpendicular cross-sections of vessels and FDs were extracted and described in terms of area, perimeter, and circularity. The geometrical parameters from each vessel were paired point-by-point with those from FDs.Results: FD cross-sections are typically circular, regardless of the vessel's morphology. The area and perimeter of FD cross-sections were smaller than those of the vessel in 66.8% of the data; however, they were larger in 30.1%, suggesting that the vessel is radially stretching to accommodate the FD expansion. In 3.1% of the slices, the FD area was larger than the vessel, but its perimeter was smaller, indicating a change in the shape of the artery.Conclusions: Expansion of FD is generally restricted by the morphology of the vessel, but the vessel is also able to adapt to the device by changing its shape or stretching.","PeriodicalId":94006,"journal":{"name":"Expert review of medical devices","volume":" ","pages":"379-386"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quantifying insertional effects in deep brain stimulation: clinical outcomes and neurophysiological mechanisms.

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-17 DOI: 10.1080/17434440.2025.2480660

Aaron Lawson McLean, Jakob Nemir

{"title":"Quantifying insertional effects in deep brain stimulation: clinical outcomes and neurophysiological mechanisms.","authors":"Aaron Lawson McLean, Jakob Nemir","doi":"10.1080/17434440.2025.2480660","DOIUrl":"10.1080/17434440.2025.2480660","url":null,"abstract":"Introduction: Deep brain stimulation (DBS) has revolutionized the treatment of various neurological and psychiatric disorders. However, recent findings highlight the significant clinical and molecular responses elicited by the mere insertion of DBS electrodes, termed 'insertional effects.' This review explores the clinical manifestations and underlying mechanisms of these effects, emphasizing their implications for neuromodulation therapies.Areas covered: A comprehensive literature search was conducted, examining studies that document the clinical benefits observed immediately following DBS electrode implantation in conditions such as Parkinson's disease, epilepsy, chronic pain, and psychiatric disorders. The review delves into the molecular and cellular mechanisms, including neuroinflammatory responses and ion channel dynamics, that contribute to these insertional effects. Additionally, the potential for these effects to predict DBS efficacy and inform the development of closed-loop DBS systems is discussed.Expert opinion: The insertional effects of DBS represent a crucial yet underappreciated phenomenon with significant implications for optimizing therapeutic protocols and enhancing patient outcomes. Recognizing and harnessing these effects could lead to more personalized and effective neuromodulation strategies, advancing the field of DBS and improving treatment for a range of neurological and psychiatric disorders.","PeriodicalId":94006,"journal":{"name":"Expert review of medical devices","volume":" ","pages":"285-291"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Percutaneous auricular neuromodulation for postoperative analgesia.

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-05 DOI: 10.1080/17434440.2025.2474731

John J Finneran Iv, Brian M Ilfeld

{"title":"Percutaneous auricular neuromodulation for postoperative analgesia.","authors":"John J Finneran Iv, Brian M Ilfeld","doi":"10.1080/17434440.2025.2474731","DOIUrl":"10.1080/17434440.2025.2474731","url":null,"abstract":"Introduction: Postoperative pain is often severe, with many patients still experiencing significant pain upon discharge. While opioids are effective for pain relief, they have numerous side effects and carry a high risk for misuse and dependence. Auricular electric stimulation, a form of neuromodulation, offers a promising alternative by electrically stimulating nerves of the auricle to modulate central pain pathways, potentially reducing postoperative pain and opioid requirements.Areas covered: This review, based on a search of the MEDLINE/PubMed, Scopus, and Cochrane review online sources from 1980 to 2024, discusses the use of auricular electric stimulation as a form of neuromodulation for management of postoperative pain focusing on the available evidence and future avenues for research.Expert opinion: Percutaneous auricular nerve stimulation offers a promising neuromodulation technique for managing postoperative pain. By modulating central pain processing through peripheral stimulation, this approach may reduce pain during recovery. Small pilot studies have suggested that auricular stimulation may lower pain intensity and reduce opioid consumption after surgery; however, further research is needed regarding both potential benefits and risks. As a minimally invasive technique, percutaneous auricular stimulation may provide a valuable adjunct to multimodal analgesia, especially in patients at risk of opioid-related complications.","PeriodicalId":94006,"journal":{"name":"Expert review of medical devices","volume":" ","pages":"339-348"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comments on: 'Two-year outcomes using fast-acting sub-perception therapy for spinal cord stimulation: results of a real-world multicenter study in the United States'. 评论："使用速效亚感知疗法进行脊髓刺激的两年结果：美国真实世界多中心研究的结果"。

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-19 DOI: 10.1080/17434440.2025.2479808

Triwiyanto T, I Putu Alit Pawana, Sari Luthfiyah

引用次数: 0

Printing hearts: three-dimensional printing as a transformative technology in transcatheter mitral valve interventions.

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-03-13 DOI: 10.1080/17434440.2025.2477608

Apurva H Bharucha, Mehdi Eskandari

引用次数: 0

Response to letter to the editor: "Two-year outcomes using fast-acting sub-perception therapy for spinal cord stimulation: results of a real-world multicenter study in the United States".

Expert review of medical devices Pub Date : 2025-04-01 Epub Date: 2025-04-02 DOI: 10.1080/17434440.2025.2479820

Clark Metzger

引用次数: 0