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Establishment of an Auscultation System for Arteriovenous Fistula Stenosis 動靜脈瘻管聽診系統之建立

Establishment of an Auscultation System for Arteriovenous Fistula Stenosis 動靜脈瘻管聽診系統之建立. Presenter : Wei-Liang Hong Advisor : Dr. Chun- Ju Hou. Outline. Problems and Rationale Purpose and Specific Aims Background and Literatures Review Materials and Methods

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Establishment of an Auscultation System for Arteriovenous Fistula Stenosis 動靜脈瘻管聽診系統之建立

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  1. Establishmentofan AuscultationSystem for Arteriovenous Fistula Stenosis動靜脈瘻管聽診系統之建立 Presenter: Wei-Liang Hong Advisor:Dr. Chun-JuHou

  2. Outline • Problems and Rationale • Purpose and Specific Aims • Background and Literatures Review • Materials and Methods • Preliminary Results and Discussion • Future works • References

  3. Problems and Rationale number of people (millions) • Incidence of renal failure and dialysis Source: USRDS

  4. Problems and Rationale • Treatments for renal failure • Kidney transplantation • Dialysis • Peritoneal dialysis: 9.17% • Hemodialysis: 90.83% • Native arteriovenous(AV) fistula • Synthetic AV shunt (Graft) • U-type transplanted fistula • Linear transplanted fistula

  5. Problems and Rationale AV graft Native AV fistula

  6. Problems and Rationale • Complications of arteriovenous fistula (AVF) • Infection • Bleeding • Vascular access dysfunction • Stenosis • Embolism • Steal syndrome • Venous hypertension • …..

  7. Problems and Rationale • Assessments for AVF function • Palpated with the fingers • Strength of pulse, thrill • Auscultation • Appear high-pitched bruit or sea-gull murmur (200 ~ 800 Hz) when stenosis occurs • Angiography • Ultrasound • CT

  8. Problems and Rationale • Problems in AVF care • Insufficient auscultation skill • Subjective • Depend on individual experience • Insufficient manpower • Lack of objectively computerized sound analysis

  9. Problems and Rationale • Littmann 3200 Bluetooth Stethoscope • Frequency of 4K Hz • Anti-noise high • TransmissionforBluetooth • USD-$372.99

  10. Purpose and Specific Aims • Establishment of an auscultation system for the evaluation of arteriovenous fistula stenosis • Hardware and software design • Experimental testing

  11. Background & Literatures Review Yen-Nien Wang, Chih-Yang Chan, & Shi-Jun Chou, “The Detection of Arteriovenous Fistula Stenosis forHemodialysis Based on Wavelet Transform”, International Journal of Advanced Computer Science, Vol. 1, Pp. 16-22, Jul. 2011. (Impact Factor 0.740) • Analog circuits • Wavelet transform • STFT • FFT • Hilbert transform

  12. Background & Literatures Review (a) Stenosis-free representation; (b) Stenosis representation.

  13. Background & Literatures Review Stenosis-free Stenosis

  14. Background & Literatures Review Stenosis-free Stenosis

  15. Background & Literatures Review Pablo V´asquez, Marco Mungu´ıa M., Members IEEE,lisabethMattsson, and BengtMandersson, “Application of the Empirical Mode Decomposition in the study ofmurmurs from Arteriovenous Fistula Stenosis”, 32nd Annual International Conference of the IEEE EMBSBuenos Aires, Argentina, August 31 - September 4, 2010 • Equipment (BIOPAC, Inc.) • 0.05~5k(Hz) • Matlab • Analysis method • Empirical Mode Decomposition (EMD)

  16. Background & Literatures Review Pablo V´asquez, Marco Mungu´ıa M., Members “Frequency tracking of resonant-like sounds from audio recordings of Arterio-Venous Fistula Stenosis”, 2012 IEEE International Conference on Bioinformatics and Biomedicine Workshops (BIBMW) • Equipment (BIOPAC, Inc.) • MP-150 system • Matlab • Analysis method • Windkessel Model • AR modeling • STFT

  17. Background & Literatures Review • CHIRPS ENCOUNTERED IN RECORDINGS.

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