Algorithms for Automated Pointing of Cardiac Imaging Catheters

This paper presents a modified controller and expanded algorithms for automatically positioning cardiac ultrasound imaging catheters within the heart to improve treatment of cardiac arrhythmias such as atrial fibrillation. Presented here are a new method for controlling the position and orientation of a catheter, smoother and more accurate automated catheter motion, and initial results of image processing into clinically useful displays. Ultrasound imaging (intracardiac echo, or ICE) catheters are steered by four actuated degrees of freedom (DOF) to produce bi-directional bending in combination with handle rotation and translation. Closed form solutions for forward and inverse kinematics enable position control of the catheter tip. Additional kinematic calculations enable 1-DOF angular control of the imaging plane. The combination of positioning with imager rotation enables a wide range of visualization capabilities, such as recording a sequence of ultrasound images and reconstructing them into 3D or 4D volumes for diagnosis and treatment. The algorithms were validated with a robotic test bed and the resulting images were reconstructed into 3D volumes. This capability may improve the efficiency and effectiveness of intracardiac catheter interventions by allowing visualization of soft tissues or working instruments. The methods described here are applicable to any long thin tendon-driven tool (with single or bi-directional bending) requiring accurate tip position and orientation control.Engineering and Applied Science

Vascular anomaly in bilateral ectopic kidney: a case report

Ectopic kidney occurs as a result of a halt in migration of kidneys to their normal locations during embryonal period. While kidneys ascend through pelvis, they receive new branches from vessels (iliac and aorta) close to them. When they reach the highest point, they receive new branches from aorta and the former branches degenerate. Renal vessels do not degenerate in the ectopic caudal kidney, more than one accessory and polar arteries may arise. In various studies, a possibility of association between presence of multiple renal arteries and hypertension, has been reported. We aimed to present a case with bilateral ectopic kidney and vascular anomaly associated with hypertension and renal dysfunction

Contrast-Enhanced Doppler Ultrasound of Renal Artery Stenosis.

Over the past few years, there has been extensive research for a reliable, noninvasive, and nonionizing imaging method to screen for renal artery stenosis (RAS). Doppler ultrasound (US) is one of many modalities that have been evaluated for the detection of RAS. The lack of standardization in examination protocols and diagnostic criteria, as well as the wide differences in reported accuracy among different laboratories, however, have prevented universal acceptance of this technique as a reliable screening test for RAS. Recently, the introduction of US contrast agents has substantially expanded the potentials of color Doppler US. The use of microbubble echo enhancers in combination with harmonic Doppler imaging has been shown to improve diagnostic confidence by improving the operator's ability to visualize the renal arteries, and to significantly reduce the number of equivocal examinations. In addition, contrast-enhanced harmonic Doppler US can currently provide objective functional assessment of RAS through analysis of time-intensity renal enhancement curve. State-of-the-art contrast-enhanced Doppler US seems to have the potential to become a useful screening test for patients at risk from renovascular hypertension and a tool for follow-up of patients who undergo revascularization procedure