Design of a bifurcated stent graft, with its accompanying delivery system.

Abdominal Aortic Aneurysms (AAA) haemorhaging is a life-threatening disease. An aneurysm is a permanent swelling of an artery due to a weakness in its wall. Current surgical repair involves opening the chest or abdomen, gaining temporary vascular control of the aorta and suturing a prosthetic graft to the healthy aorta within the aneurysm itself The outcome of this surgical approach is not perfect, and the quality of life after this repair is impaired by postoperative pain, sexual dysfunction, and a lengthy hospital stay resulting in high health costs. All these negative effects are related to the large incision and extensive tissue dissection. Endovascular grafting is an alternative to the standard surgical method. This treatment is a less invasive method of treating aortic aneurysms. It involves a surgical exposure of the common femoral arteries where the stent graft can be inserted through by an over-the-wire technique. All manipulations are controlled from a remote place by the use of a catheter and this technique avoids the need to directly expose the diseased artery through a large incision or an extensive dissection. The proposed design method outlined in this project is to develop the endovascular approach. The main aim is to design an unitary bifurcated stent graft (1 e- bifurcated graft as a single component) to treat these Abdominal Aortic Aneurysms. This includes the delivery system and deployment mechanism necessary to first accurately position the stent graft across the aneurysm sac and also across the iliac bifurcation, and secondly fix the stent graft in position by using expandable metal stents. Thus, excluding the aneurysm from the circulation and therefore preventing rupture. Miniaturisation is a critical aspect of this design, as the smaller the crimped stent graft the easier to guide through the vascular system to the desired location. Biocompatibility is an important aspect. The preferred materials for this prosthesis are to use Shape Memory Alloys for the stent and a multifilament fabric for the graft. A taper design is applied for the geometry as this gives a favourable flow characteristic and reduced wave reflections. Adequate testing of the stent graft to prove its durability and the ease of the method of deployment is a prerequisite. A bench test facility has being designed and build to replicate the cardiovascular system and the disease in question aortic aneurysms at the iliac bifurcation. The testing here shows the feasibility of the proposed delivery system and the durability of the stent graft across the aneurysm sac. Finally, these endovascular treatments offer the economic advantage of short hospital stays or even treatment as an outpatient, as well as elimination of the need for postoperative intensive care The risk of developing an aneurysm increases with age, that is one of the mam reasons to look for less invasive ways of treating aneurysms. Consequently, there is enormous pressure to develop and use these devices rapidly.

Development of an inspection regime for on-site domestic wastewater treatment systems

The overall purpose of this study was to develop a thorough inspection regime for onsite wastewater treatment systems, which is practical and could be implemented on all site conditions across the country. With approximately 450,000 onsite wastewater treatment systems in Ireland a risk based methodology is required for site selection. This type of approach will identify the areas with the highest potential risk to human health and the environment and these sites should be inspected first. In order to gain the required knowledge to develop an inspection regime in-depth and extensive research was earned out. The following areas of pertinent interest were examined and reviewed, history of domestic wastewater treatment, relevant wastewater legislation and guidance documents and potential detrimental impacts. Analysis of a questionnaire from a prior study, which assessed the resources available and the types of inspections currently undertaken by Local authorities was carried out. In addition to the analysis of the questionnaire results, interviews were carried out with several experts involved in the area of domestic wastewater treatment. The interview focussed on twelve key questions which were directed towards the expert’s opinions on the vital aspects of developing an inspection regime. The background research, combined with the questionnaire analysis and information from the interviews provided a solid foundation for the development of an inspection regime. Chapter 8 outlines the inspection regime which has been developed for this study. The inspection regime includes a desktop study, consultation with the homeowners, visual site inspection, non-invasive site tests, and inspection of the treatment systems. The general opinion from the interviews carried out, was that a standardised approach for the inspections was necessary. For this reason an inspection form was produced which provides a standard systematic approach for inspectors to follow. This form is displayed in Appendix 3. The development of a risk based methodology for site selection was discussed and a procedure similar in approach to the Geological Survey of Irelands Groundwater Protection Schemes was proposed. The EPA is currently developing a risk based methodology, but it is not available to the general public yet. However, the EPA provided a copy of a paper outlining the key aspects of their methodology. The methodology will use risk maps which take account of the following parameters: housing density, areas with inadequate soil conditions, risk of water pollution through surface and subsurface pathways. Sites identified with having the highest potential risk to human health and the environment shall be inspected first. Based on the research carried out a number of recommendations were made which are outlined in Chapter 10. The principle conclusion was that, if these systems fail to operate satisfactorily, home owners need to understand that these systems dispose of the effluent to the 'ground' and the effluent becomes part of the hydrological cycle; therefore, they are a potential hazard to the environment and human health. It is the owners, their families and their neighbours who will be at most immediate risk.