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Patil et al., "Management of thoracic insufficiency syndrome in patients with Jarcho-Levin syndrome using VEPTRs (vertical expandable prosthetic titanium ribs)," Journal of Bone and Joint Surgery: American Volume, vol.
Campbell and Hell-Vocke (3) investigated the results of VEPTR implantation in 21 children with congenital scoliosis and fused ribs; three of the children had already had a posterior spinal fusion procedure performed.
Indications for VEPTR have expanded to include various types of early onset scoliosis without intrinsic chest wall deformity as a means of providing extra-spinal correction and avoiding stiffening of the spine and autofusion.
Ramirez and associates (15) reviewed their results of 17 VEPTR implantations.
Recently, Akbarnia and Emans (17) reviewed the literature regarding the complications seen in the use of VEPTRs. Reports of infection were quite common, with some investigators noting a risk of 1.9% per procedure (initial VEPTR placement as well as subsequent lengthenings).
Although the VEPTR was not available at that time, Dr Lim put Alice on the waiting list, ready to call her in once it arrived.
When the titanium rib became available to KKH in the first week of August 2010, Alice joined two other children - a 14 month old girl and a two-year old boy - as the first ones in Southeast Asia to have the VEPTR device implanted.
The goal of the VEPTR is to make one (or both) sides of the chest larger, longer or more normal in shape so as to provide more room for the lungs to expand or grow.
The second-generation VEPTR II has the same basic design but features additional components such as rib hooks, transverse bars, an S rod and a proximal extension that provide orthopedic surgeons with more options to address juvenile chest wall and/or spinal defects.
The first titanium rib went to its fracture-pinned muse on April 19,1989 (technically, the boy received the second VEPTR--Campbell accidentally broke the first one by repeatedly bending its loops with vice-grips).The success of the boy's second surgery marked the start of a new chapter in Campbell's quest to make the VEPTR globally available on a mass-market scale.
Food and Drug Administration (FDA) authorized a sole site feasibility study of the VEPTR device with Techmedica Co.
If the same situation came up today, there would still be only the VEPTR available to us because it's the only FDA-approved device for TIS.
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