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Zhao K, Varghese P J G, Chen P, Hu J. Developing a transcatheter injectable nanoclay- alginate gel for minimally invasive procedures. J Mech Behav Biomed Mater 2024; 152:106448. [PMID: 38335649 PMCID: PMC10923083 DOI: 10.1016/j.jmbbm.2024.106448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/16/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
Shear-thinning materials have held considerable promise as embolic agents due to their capability of transition between solid and liquid state. In this study, a laponite nanoclay (NC)/alginate gel embolic agent was developed, characterized, and studied for transcatheter based minimally invasive procedures. Both NC and alginate are biocompatible and FDA-approved. Due to electrostatic interactions, the NC/alginate gels exhibit shear-thinning properties that are desirable for transcatheter delivery. The unique shear-thinning nature of the NC/alginate gel allows it to function as a fluid-like substance during transcatheter delivery and as a solid-like embolic agent once deployed. To ensure optimal performance and safety in clinical applications, the rheological characteristics were thoroughly investigated to optimize the mechanical properties of the NC/alginate gel, including storage modulus, yield stress/strain, and thixotropy. To improve physicians' experience and enhance the predictability of gel delivery, a combination of experimental and theoretical approaches was used to assess the injection force required for successful delivery of the gel through clinically employed catheters. Overall, NC/alginate gel exhibited excellent stability and tunable injectability by optimizing the composition of each component. These findings highlight the gel's potential as a robust embolic agent for a wide range of minimally invasive procedures.
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Affiliation(s)
- Keren Zhao
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, 27606, USA
| | - George Varghese P J
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, 27606, USA
| | - Peng Chen
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, 27606, USA
| | - Jingjie Hu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, 27606, USA.
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Pritchett MA, Oberg CL, Belanger A, De Cardenas J, Cheng G, Nacheli GC, Franco-Paredes C, Singh J, Toth J, Zgoda M, Folch E. Society for Advanced Bronchoscopy Consensus Statement and Guidelines for bronchoscopy and airway management amid the COVID-19 pandemic. J Thorac Dis 2020; 12:1781-1798. [PMID: 32642084 PMCID: PMC7330355 DOI: 10.21037/jtd.2020.04.32] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/03/2020] [Indexed: 01/08/2023]
Affiliation(s)
| | | | - Adam Belanger
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | | | | | - Gustavo Cumbo Nacheli
- Spectrum Health, Michigan State University School of Human Medicine, Grand Rapids, MI, USA
| | - Carlos Franco-Paredes
- University of Colorado Anschutz Medical Center, Aurora, CO, USA
- Hospital Infantil de Mexico, Federico Gomez, Mexico City, Mexico
| | - Jaspal Singh
- Atrium Health and Levine Cancer Institute, Charlotte, NC, USA
| | - Jennifer Toth
- Penn State Health, Hershey Medical Center, Hershey, PA, USA
| | - Michael Zgoda
- Atrium Health and Levine Cancer Institute, Charlotte, NC, USA
| | - Erik Folch
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Uniportal Video-assisted Thoracoscopic Surgery for Pulmonary Aspergilloma: A Report of 5 Cases. Surg Laparosc Endosc Percutan Tech 2019; 29:e37-e40. [PMID: 31083021 DOI: 10.1097/sle.0000000000000663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pulmonary aspergilloma is an uncommon pulmonary disease that complicated with many other respiratory disorders. Despite advances in medication, surgical treatment continues to form the basis of aspergilloma treatment. However, the use of uniportal video-assisted thoracoscopic surgery is extremely limited in pulmonary aspergilloma. In this report, 5 patients who underwent anatomic pulmonary resection safely with uniportal video-assisted thoracoscopic surgery technique without requiring a traditional thoracotomy were presented.
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Gaucher S, Lococo F, Guinet C, Bobbio A, Magdeleinat P, Bouam S, Regnard JF, Alifano M. Indications and Results of Reconstructive Techniques with Flaps Transposition in Patients Requiring Complex Thoracic Surgery: A 12-Year Experience. Lung 2016; 194:855-63. [PMID: 27395425 DOI: 10.1007/s00408-016-9921-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 07/02/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Flap transposition is an infrequent but far from exceptional thoracic surgical procedure. The aim of this retrospective study was to report our experience in a referral unit of general thoracic surgery analyzing the early results after flap transposition. METHODS We retrospectively analyzed the clinical records, surgical notes, and postoperative results of a cohort of patients who underwent flap transposition in our unit from November 2000 to February 2013. RESULTS Overall, a surgical approach adopting flap reconstruction techniques was performed in 81 patients (54 males, 27 females) with a median age of 62 years (range 20-87). Flap transposition was necessary to reconstruct chest wall after resection for malignancy (27 patients), to repair intrathoracic viscera perforation (15 patients), and to fill residual cavities secondary to pulmonary/pleural infection (39 patients). A pedicle muscle flap was transposed in most of cases (64 pts, 79 %), while in the remaining 17 cases (11 %), an omental flap was used. There were no immediate postoperative complications, while three in-hospital deaths occurred due to respiratory or multiorgan failure. Among patients undergone flap transposition to fill a residual cavity, we observed a recurrent bronchopleural fistula in three patients (7.7 %); such patients were treated by repeat flap transposition (2 cases) and by repeat cavernostomy (1 case). CONCLUSION Flap transposition may be indicated as part of a multimodal treatment for severely ill patients requiring complex thoracic surgery.
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Affiliation(s)
- Sonia Gaucher
- Faculté de Médecine, Université Paris Descartes, Paris, France. .,Service de Chirurgie Thoracique, AP-HP, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France. .,Service de Chirurgie Générale, Plastique et Ambulatoire, AP-HP, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, 75 014, Paris, France.
| | - Filippo Lococo
- Unit of Thoracic Surgery, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Claude Guinet
- Service de Radiologie, AP-HP, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France
| | - Antonio Bobbio
- Service de Chirurgie Thoracique, AP-HP, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France
| | - Pierre Magdeleinat
- Service de Chirurgie Thoracique, AP-HP, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France
| | - Samir Bouam
- Département d'Information Médicale, AP-HP, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France
| | - Jean-François Regnard
- Faculté de Médecine, Université Paris Descartes, Paris, France.,Service de Chirurgie Thoracique, AP-HP, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France
| | - Marco Alifano
- Faculté de Médecine, Université Paris Descartes, Paris, France.,Service de Chirurgie Thoracique, AP-HP, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France
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[Multidisciplinary approach of ventilated necrotizing pneumonia]. MEDECINE INTENSIVE REANIMATION 2013; 22:34-44. [PMID: 32288731 PMCID: PMC7117818 DOI: 10.1007/s13546-012-0646-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 12/06/2012] [Indexed: 11/05/2022]
Abstract
Les pneumopathies infectieuses peuvent se compliquer, du fait de facteurs liés aux germes, à l’hôte ou à l’interaction entre les deux, par la survenue d’une nécrose et/ou d’une destruction du parenchyme pulmonaire. La nécrose et la destruction du parenchyme pulmonaire sont à l’origine de deux entités cliniques principales, les abcès pulmonaires et les pneumonies nécrosantes (PN). Les PN sont des entités rares mais dont le pronostic est redoutable. Elles sont caractérisées par une hépatisation diffuse, possiblement bilatérale du parenchyme pulmonaire avec cavitations et nécrose. Les PN sont généralement associées à un sepsis sévère et à une insuffisance respiratoire aiguë. Nous envisagerons la physiopathologie et le traitement médical qui comprend des mesures symptomatiques, le support des différentes défaillances d’organe, en particulier respiratoires, et le traitement antibiotique. Les indications chirurgicales et leurs modalités seront aussi détaillées. Une prise en charge multidisciplinaire associant réanimateurs, pneumologues, infectiologues, radiologues, chirurgiens et kinésithérapeutes doit permettre d’améliorer les taux de survie et surtout la qualité de vie des patients à distance d’une PN.
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