Expert review of medical devices
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Expert Rev Med Devices · Jan 2016
ReviewDevelopments in mechanical thrombectomy devices for the treatment of acute ischemic stroke.
Several recent prospective randomized controlled trials of endovascular stroke therapy using latest generation thrombectomy devices, so called stent-retrievers, have shown significantly improved clinical outcome compared to the standard treatment with intra-venous thrombolysis using r-tPA alone. Despite some differences in inclusion criteria between these studies, all required non-invasive vessel imaging to proof occlusion of a major brain supplying vessel. ⋯ Patients with small infarct volume, severe neurological deficits and in whom thrombectomy can be initiated within the first 6 hours after symptom onset seem to benefit the most. Therefore, mechanical thrombectomy using stent-retrievers in addition to intra-venous thrombolysis is recommended for the treatment of acute ischemic stroke with proven major vessel occlusion in the anterior circulation.
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Expert Rev Med Devices · Jan 2016
ReviewVisions on the future of medical devices in spinal cord stimulation: what medical device is needed?
Recently burst stimulation and 10 kHz stimulation have been developed as novel stimulation designs. Both appear to be superior to classical tonic stimulation in the amount of responders and the amount of pain suppression and have as an extra advantage that they are paresthesia-free. ⋯ This evolution mandates a new approach in the development of internal pulse generators, and the most obvious approach is to develop an upgradable stimulator, on which new stimulation designs can be downloaded, analogous to the apps people download on their smartphones. This will create a shift from hardware driven products to software driven stimulators.
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Expert Rev Med Devices · Jan 2016
ReviewAdvances in supraglottic airway devices for the management of difficult airways in children.
There are innumerable tools and devices available to facilitate airway management and life-saving gas exchange of the patient's lungs. Over the years, various designs and generations of supraglottic airway devices have proven to be effective in accomplishing this function. ⋯ Older supraglottic airway devices since the 1980's have been validated in multiple clinical trials to be safe and effective in the pediatric population, however there is also sufficient evidence that the newer designs have features that help overcome some limitations. These newer designs and features are effective in managing both the normal and difficult pediatric airway, and will be discussed in this comprehensive review.
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Expert Rev Med Devices · Jan 2016
ReviewFrom drug eluting stents to bioresorbable scaffolds; to new horizons in PCI.
Drug eluting stents and particularly the fully bioresorbable drug-eluting scaffolds herald a new era in percutaneous treatment of coronary artery disease. There has been tremendous progress in drug eluting stents with fully biodegradable coating polymers and polymer-free devices with reservoir technology planting the anti-proliferative drug. ⋯ Enhanced mechanical flexibility that provides superior conformability to the vessel wall, resumption of the vasoreactivity in the follow-up period and improving visualization on non-invasive imaging modalities are some of the supremacies of the fully bioresorbable scaffolds. In this review, we aim to give a general view on the latest developments in metallic drug eluting stents and fully bioresorbable scaffolds.
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Expert Rev Med Devices · Jan 2016
ReviewUpdate on the use of abdominal and thoracic endografts for treating aortic aneurysms.
Endovascular abdominal and thoracic aneurysm repair has heralded a paradigm shift in the management of abdominal and thoracic aortic aneurysms. Randomized controlled trials have suggested superior short-term and equivalent long-term outcomes of endovascular repair compared with open surgery. ⋯ The advent of fenestrated and branched endografts have made endovascular repair of thoracoabdominal and juxtarenal aneurysms possible. Continued evolution of endograft technology will maximize the benefit and minimize complications in patients with a range of aneurysmal disease.