Sudden failure of dual channel pulse generators
Identifieur interne : 003717 ( Main/Exploration ); précédent : 003716; suivant : 003718Sudden failure of dual channel pulse generators
Auteurs : François Alesch [Autriche]Source :
- Movement Disorders [ 0885-3185 ] ; 2005-01.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Deep Brain Stimulation (instrumentation), Deep Brain Stimulation (methods), Deep brain stimulation, Electric Power Supplies, Electrodes, Implanted, Equipment Design, Equipment Failure, Equipment Failure Analysis, Follow-Up Studies, Humans, Nervous system diseases, Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Pulse generator, Subthalamic Nucleus (radiation effects), Sudden, deep brain stimulation, hardware failure, pulse generator.
- MESH :
- instrumentation : Deep Brain Stimulation.
- methods : Deep Brain Stimulation.
- radiation effects : Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Electric Power Supplies, Electrodes, Implanted, Equipment Design, Equipment Failure, Equipment Failure Analysis, Follow-Up Studies, Humans.
Abstract
An Editor‐Solicited Manufacturer ResposeEditor‐Solicited Manufacturer Respose to this article has been published in Movement Disorders. We report a series of four sudden hardware failures in dual channel pulse generators implanted for chronic stimulation of the subthalamic nucleus in the treatment of Parkinson's disease. In all cases, a sudden and severe deterioration of the patient's neurological condition occurred with symptoms similar to those present before surgery. In all cases, destructive analysis of the generator revealed a fracture of the wire bonds connecting the battery to the hybrid (electronic) part of the pulse generator. This fracture led to repeated Power On Resets, bringing the parameter settings back to default (factory settings). As a cause, we propose that relative movements between the hybrid and the battery led to low cycle fatigue fractures due to insufficient stiffness of the device. That three of four failures occurred when the implant was in the infracostal region makes it likely that the fractures depend on the mechanical stress applied to the device. The efficacy of the therapy resumed immediately after device replacement. As a corrective measure, the manufacturer has added epoxy between both components, increasing significantly the stiffness of the device. © 2004 Movement Disorder Society
Url:
DOI: 10.1002/mds.20354
Affiliations:
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Le document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2005-01">2005-01</date><biblScope unit="vol">20</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="64">64</biblScope><biblScope unit="page" to="66">66</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">488D4519DCF047C5F5B9002E1F0ECE25ACA2B676</idno><idno type="DOI">10.1002/mds.20354</idno><idno type="ArticleID">MDS20354</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep Brain Stimulation (instrumentation)</term><term>Deep Brain Stimulation (methods)</term><term>Deep brain stimulation</term><term>Electric Power Supplies</term><term>Electrodes, Implanted</term><term>Equipment Design</term><term>Equipment Failure</term><term>Equipment Failure Analysis</term><term>Follow-Up Studies</term><term>Humans</term><term>Nervous system diseases</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Pulse generator</term><term>Subthalamic Nucleus (radiation effects)</term><term>Sudden</term><term>deep brain stimulation</term><term>hardware failure</term><term>pulse generator</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="radiation effects" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Electric Power Supplies</term><term>Electrodes, Implanted</term><term>Equipment Design</term><term>Equipment Failure</term><term>Equipment Failure Analysis</term><term>Follow-Up Studies</term><term>Humans</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Brutal</term><term>Générateur impulsion</term><term>Parkinson maladie</term><term>Stimulation cérébrale profonde</term><term>Système nerveux pathologie</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">An Editor‐Solicited Manufacturer ResposeEditor‐Solicited Manufacturer Respose to this article has been published in Movement Disorders. We report a series of four sudden hardware failures in dual channel pulse generators implanted for chronic stimulation of the subthalamic nucleus in the treatment of Parkinson's disease. In all cases, a sudden and severe deterioration of the patient's neurological condition occurred with symptoms similar to those present before surgery. In all cases, destructive analysis of the generator revealed a fracture of the wire bonds connecting the battery to the hybrid (electronic) part of the pulse generator. This fracture led to repeated Power On Resets, bringing the parameter settings back to default (factory settings). As a cause, we propose that relative movements between the hybrid and the battery led to low cycle fatigue fractures due to insufficient stiffness of the device. That three of four failures occurred when the implant was in the infracostal region makes it likely that the fractures depend on the mechanical stress applied to the device. The efficacy of the therapy resumed immediately after device replacement. As a corrective measure, the manufacturer has added epoxy between both components, increasing significantly the stiffness of the device. © 2004 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Autriche</li></country><region><li>Vienne (Autriche)</li></region><settlement><li>Vienne (Autriche)</li></settlement></list><tree><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Alesch, Francois" sort="Alesch, Francois" uniqKey="Alesch F" first="François" last="Alesch">François Alesch</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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