neurosurgery image of valves strata™ valve the adjustable delta ® valve
TRANSCRIPT
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Neurosurgery
Image of valves
Strata™ ValveThe Adjustable Delta® Valve
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Neurosurgery
RegularSmall
• 體外調節控制閥的壓力
• 無需反覆更換閥門,減少手術費用
• 避免二次手術創傷
• 抗虹吸閥一體化設計,同時解決虹吸現象和壓力分級
Strata Valve
42866 42856
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Neurosurgery
Strata ValveCutaway of Regular Valve
Delta Chamber
Reservoir
Valve Mechanism
Proximal Occluder
Inlet Connector
Outlet Connector
Distal Occluder
Polypropylene Base
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Neurosurgery
紅寶石圓錐
流體壓力彈簧
磁性轉軸
性能级别
轉軸定位彈簧
轉軸鎖定彈簧設計,
降低閥門受外界磁場干擾機會
不對稱齒和特殊底盤設計將外磁場影響減小到最小程度
Strata Valve MechanismHow it works...
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Neurosurgery
Strata Valve Performance CharacteristicsFive Performance Levels
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Neurosurgery
Strata ValveAdjustment Tools
Locator Tool Adjustment ToolIndicator Tool
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Neurosurgery
輕鬆四步體外調壓 :
1. Locator Tool 底座定位2. Indicator Tool 指示盤讀數3. Adjustment Tool 磁性轉盤調壓4. Indicator Tool 指示盤確認結果
體外調壓工具,多重確認壓力,確保安全
Strata ValveAdjustment Tools
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Neurosurgery
Strata ValveValve Adjustment Reliability
X-ray Hand tool
0.5 1.0
1.0 0.5
1.5 0.5
2.0 2.5
•All initial valve settings were confirmed by X-ray
•All post-operative adjustments were confirmed by X-ray
•238 valve adjustments
•4 instances where the x-ray did not match patient chart
98% ACCURACY RATE
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Neurosurgery
Codman Programmable Hakim Valve FDA Study
•377 Patients
–235 First Insertion
–142 Revisions
•540 total valve adjustments.
•118 discrepancies between x-rays and patient charts.
Error Rate of 22%
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Neurosurgery
Image of X-Ray
0.5 1.0 1.5 2.0 2.5
Dot Code
Magnet
根據磁性轉軸相對於編碼的方向用 X-Ray確認壓力級別
Strata ValveX-Ray
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Neurosurgery
Strata NSC ValvePressure/Flow Ranges
Performance Level Old Description
Performance Level 0.5 Low-Low Pressure
Performance Level 1.0 Low Pressure
Performance Level 1.5 Medium Pressure
Performance Level 2.0 High Pressure
Performance Level 2.5 New higher pressure to match the upper Hakim valve range.
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Neurosurgery
競爭對手
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Neurosurgery
Integra NeuroCareNovus Valve
Hydrodynamic Leverage 8:1 槓桿14 cm H20 > 10 cm H20 Under drainage 引流不足
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Neurosurgery
Impact of Hydrodynamic Leverage
• The hydrodynamic leverage ratio determines the amount of added resistance the anti-siphon mechanism will contribute in the upright position.
• To determine this added resistance, the negative hydrostatic column is divided by the leverage ratio to determine the added resistance.
Example: Hydrodynamic Leverage: 8:1
Negative Hydrostatic Column: 48cm H2O
Additional Shunt Resistance: 48/8 = 6 cm H2O
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Neurosurgery
Codman SiphonGuard DeviceSiphonGuard(Flow Restrictor)
Secondary Flow
Primary Flow
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Neurosurgery
Codman SiphonGuardFacts
• The siphon guard is merely a flow restrictor. A ball in the center of the device diverts fluid through a tortuous circumferential flow path, when the patient is upright.
• 當病人站立時其圓球會阻塞住主通道 ,CSF由側細支流流通 ,其機械原理是限制其流速。
• The small flow path is highly susceptible to occlusion.• 因其側細支流通道極小 ,阻塞機率極高。• The product was recalled in 2001, reportedly due to
performance issues.• 產品曾於 2001年被原廠招回 ,主要是因 CSF引流問題。