Real-Time Electrical Bioimpedance Characterization of Neointimal Tissue for Stent Applications

Current state of the art and future directions for implantable sensors in medical technology: Clinical needs and engineering challenges

Implantable sensors have revolutionized the way we monitor biophysical and biochemical parameters by enabling real-time closed-loop intervention or therapy. These technologies align with the new era of healthcare known as healthcare 5.0, which encompasses smart disease control and detection, virtual care, intelligent health management, smart monitoring, and decision-making. This review explores the diverse biomedical applications of implantable temperature, mechanical, electrophysiological, optical, and electrochemical sensors. We delve into the engineering principles that serve as the foundation for their development. We also address the challenges faced by researchers and designers in bridging the gap between implantable sensor research and their clinical adoption by emphasizing the importance of careful consideration of clinical requirements and engineering challenges. We highlight the need for future research to explore issues such as long-term performance, biocompatibility, and power sources, as well as the potential for implantable sensors to transform healthcare across multiple disciplines. It is evident that implantable sensors have immense potential in the field of medical technology. However, the gap between research and clinical adoption remains wide, and there are still major obstacles to overcome before they can become a widely adopted part of medical practice.

Analysis of Impact of Bioimpedance on Performance of Implant Coil of Artificial Retina for Optimizing Q Factor & Bandwidth

Spiral coils are indispensable part of implantable electronics for facilitating wireless power and data transfer. Although many advanced high Q receiver design have emerged, implementing and retaining high Q in biological medium so as to improve link efficiency is challenging. This article bridges the gap between advanced techniques towards improving link efficiency and the tissue losses that deteriorates the Q factor of coil in heterogeneous tissue medium. The purpose of this research is to improve the Q factor and bandwidth of the coil in tissue medium by reducing the net conductance of the coil in tissue medium, which is comparable to the net conductance in air. Bioimpedance of each layer of the eye is modelled to identify the highly capacitive and highly conductive tissue layer in the eye. To investigate the worst-case and best-case scenario, Q factor and bandwidth of the implant coil is analysed in the eye with and without aqueous humor which is a highly conductive and capacitive tissue layer in the eye. The coil is encapsulated with breast fat which possess lowest permittivity of all body tissue. After removing the high conductive tissue layer from the implantation zone, the Q factor and bandwidth of the coil is improved by 87.5% and 97.7% respectively. It is observed that 100% Q at 10 MHz and 76.75% of bandwidth is recovered in tissue medium after using breast fat as encapsulation layer. This demonstration of coil for various test cases in tissue medium aids to device a reliable, safe and efficient wireless power/data transfer system for artificial retina.

Bioimpedance Sensing of Implanted Stent Occlusions: Smart Stent

Coronary artery disease is one of the most common diseases in developed countries and affects a large part of the population of developing countries. Preventing restenosis in patients with implanted stents is an important current medical problem. The purpose of this work is to analyse the viability of bioimpedance sensing to detect the formation of atheromatous plaque in an implantable stent. Simulations in COMSOL Multiphysics were performed to analyse the performance of the proposed bioimpedance sensing system, based on the Sheffield technique. Both non-pathological and pathological models (with atheromatous plaque), including the flow of blood were considered. Simulations with the non-pathological model showed a homogeneous distribution of the measured current intensity in the different electrodes, for every configuration. On the other hand, simulations with the pathological model showed a significant decrease of the measured current intensity in the electrodes close to the simulated atheromatous plaque. The presence of the atheromatous plaque can, therefore, be detected by the system with a simple algorithm, avoiding the full reconstruction of the image and the subsequent computational processing requirements.

[Review of studies on the biomechanical modelling of the coupling effect between stent degradation and blood vessel remodeling]

The dynamic coupling of stent degradation and vessel remodeling can influence not only the structural morphology and material property of stent and vessel, but also the development of in-stent restenosis. The research achievements of biomechanical modelling and analysis of stent degradation and vessel remodeling were reviewed; several noteworthy research perspectives were addressed, a stent-vessel coupling model was developed based on stent damage function and vessel growth function, and then concepts of matching ratio and risk factor were established so as to evaluate the treatment effect of stent intervention, which may lay the scientific foundation for the structure design, mechanical analysis and clinical application of biodegradable stent.

Bioimpedance Sensor and Methodology for Acute Pain Monitoring

The paper aims to revive the interest in bioimpedance analysis for pain studies in communicating and non-communicating (anesthetized) individuals for monitoring purpose. The plea for exploitation of full potential offered by the complex (bio)impedance measurement is emphasized through theoretical and experimental analysis. A non-invasive, low-cost reliable sensor to measure skin impedance is designed with off-the-shelf components. This is a second generation prototype for pain detection, quantification, and modeling, with the objective to be used in fully anesthetized patients undergoing surgery. The 2D and 3D time-frequency, multi-frequency evaluation of impedance data is based on broadly available signal processing tools. Furthermore, fractional-order impedance models are implied to provide an indication of change in tissue dynamics correlated with absence/presence of nociceptor stimulation. The unique features of the proposed sensor enhancements are described and illustrated here based on mechanical and thermal tests and further reinforced with previous studies from our first generation prototype.

A Comparative Study of Two Fractional-Order Equivalent Electrical Circuits for Modeling the Electrical Impedance of Dental Tissues

Background: Electrical impedance spectroscopy (EIS) is a fast, non-invasive, and safe approach for electrical impedance measurement of biomedical tissues. Applied to dental research, EIS has been used to detect tooth cracks and caries with higher accuracy than visual or radiographic methods. Recent studies have reported age-related differences in human dental tissue impedance and utilized fractional-order equivalent circuit model parameters to represent these measurements. Objective: We aimed to highlight that fractional-order equivalent circuit models with different topologies (but same number of components) can equally well model the electrical impedance of dental tissues. Additionally, this work presents an equivalent circuit network that can be realized using Electronic Industries Alliance (EIA) standard compliant RC component values to emulate the electrical impedance characteristics of dental tissues. Results: To validate the results, the goodness of fits of electrical impedance models were evaluated visually and statistically in terms of relative error, mean absolute error (MAE), root mean squared error (RMSE), coefficient of determination (R2), Nash–Sutcliffe’s efficiency (NSE), Willmott’s index of agreement (WIA), or Legates’s coefficient of efficiency (LCE). The fit accuracy of proposed recurrent electrical impedance models for data representative of different age groups teeth dentin supports that both models can represent the same impedance data near perfectly. Significance: With the continued exploration of fractional-order equivalent circuit models to represent biological tissue data, it is important to investigate which models and model parameters are most closely associated with clinically relevant markers and physiological structures of the tissues/materials being measured and not just “fit” with experimental data. This exploration highlights that two different fractional-order models can fit experimental dental tissue data equally well, which should be considered during studies aimed at investigating different topologies to represent biological tissue impedance and their interpretation.

Characterization and Monitoring of Titanium Bone Implants with Impedance Spectroscopy

Porous titanium is a metallic biomaterial with good properties for the clinical repair of cortical bone tissue, although the presence of pores can compromise its mechanical behavior and clinical use. It is therefore necessary to characterize the implant pore size and distribution in a suitable way. In this work, we explore the new use of electrical impedance spectroscopy for the characterization and monitoring of titanium bone implants. Electrical impedance spectroscopy has been used as a non-invasive route to characterize the volumetric porosity percentage (30%, 40%, 50% and 60%) and the range of pore size (100–200 and 355–500 mm) of porous titanium samples obtained with the space-holder technique. Impedance spectroscopy is proved to be an appropriate technique to characterize the level of porosity of the titanium samples and pore size, in an affordable and non-invasive way. The technique could also be used in smart implants to detect changes in the service life of the material, such as the appearance of fractures, the adhesion of osteoblasts and bacteria, or the formation of bone tissue.

Towards non-invasive characterisation of coronary stent re-endothelialisation - An in-vitro, electrical impedance study

The permanent implantation of a stent has become the most common method for ameliorating coronary artery narrowing arising from atherosclerosis. Following the procedure, optimal arterial wall healing is characterised by the complete regrowth of an Endothelial Cell monolayer over the exposed stent surface and surrounding tissue, thereby reducing the risk of thrombosis. However, excessive proliferation of Smooth Muscle Cells, within the artery wall can lead to unwanted renarrowing of the vessel lumen. Current imaging techniques are unable to adequately identify re-endothelialisation, and it has previously been reported that the stent itself could be used as an electrode in combination with electrical impedance spectroscopic techniques to monitor the post-stenting recovery phase. The utility of such a device will be determined by its ability to characterise between vascular cell types. Here we present in-vitro impedance spectroscopy measurements of pulmonary artery porcine Endothelial Cells, Human Umbilical Vein Endothelial Cells and coronary artery porcine Smooth Muscle Cells grown to confluence over platinum black electrodes in clinically relevant populations. These measurements were obtained, using a bespoke impedance spectroscopy system that autonomously performed impedance sweeps in the 1kHz to 100kHz frequency range. Analysis of the reactance component of impedance revealed distinct frequency dependent profiles for each cell type with post confluence reactance declines in Endothelial Cell populations that have not been previously reported. Such profiles provide a means of non-invasively characterising between the cell types and give an indication that impedance spectroscopic techniques may enable the non-invasive characterisation of the arterial response to stent placement.

AFM-Based Characterization Method of Capacitive MEMS Pressure Sensors for Cardiological Applications

Current CMOS-micro-electro-mechanical systems (MEMS) fabrication technologies permit cardiological implantable devices with sensing capabilities, such as the iStents, to be developed in such a way that MEMS sensors can be monolithically integrated together with a powering/transmitting CMOS circuitry. This system on chip fabrication allows the devices to meet the crucial requirements of accuracy, reliability, low-power, and reduced size that any life-sustaining medical application imposes. In this regard, the characterization of stand-alone prototype sensors in an efficient but affordable way to verify sensor performance and to better recognize further areas of improvement is highly advisable. This work proposes a novel characterization method based on an atomic force microscope (AFM) in contact mode that permits to calculate the maximum deflection of the flexible top plate of a capacitive MEMS pressure sensor without coating, under a concentrated load applied to its center. The experimental measurements obtained with this method have allowed to verify the bending behavior of the sensor as predicted by simulation of analytical and finite element (FE) models. This validation process has been carried out on two sensor prototypes with circular and square geometries that were designed using a computer-aided design tool specially-developed for capacitive MEMS pressure sensors.