2012 is coming to an end, and again it has been an exciting year for medical technology. We hand-picked some of the most interesting and most promising techniques and devices we covered this year on Medgadget. So kick back, relax and savor our highlights of the best of last year.
We already mentioned renal denervation in our 2010 best of, but this year has been the year that the market for renal denervation devices was really taking off. Renal denervation is a catheter-based procedure in which the nerve endings in the renal arteries are ablated resulting in lowered blood pressure without needing to take medications for the rest of your life. For now, the only approved indication is treatment-resistant hypertension, but studies have shown that it is cost-effective and reduces mortality compared to standard treatment, so we would be surprised if indications will not broaden in the coming years. While Medtronic’s Symplicity already was proven effective and received CE Mark in 2010, this year no less than four other manufacturers’ devices were approved in the European Union (Recor Paradise, Vessix V2, Covidien OneShot and St Jude Enlightn). We had a closer look at the design story behing the Vessix V2 in April. Moreover, trials are underway for additional indications, as Medtronic is testing its Symplicity system for chronic heart failure and renal impairment.
Focused ultrasound has the potential of non-invasively treating disorders that currently still require surgery. The ultrasound waves are focused in a single spot, creating a powerful beam able to locally ablate tissue within the body. Previous use has been mainly limited to uterine fibroids, although it has also been cleared for the treatment of bone metastases and prostate cancer. Now focused ultrasound is also an option for treatment of breast fibroadenomas, and using specialized cooling techniques it can also be used to perform brain surgery non-invasively, an application first reported by us back in 2009. Also, a laser-generated focused ultrasound technique was unveiled, which will allow for much more precise ablation of smaller targets.
Radiology has always been at the forefront of medical technology, and this year was no exception to that. One of the most impressive achievements was GE’s silent MRI system. By using a combination of specialized hardware and software, they managed to reduce the noise from jackhammer-like to almost imperceptible. Siemens on the other hand unveiled a wireless ultrasound system, purposed for interventionalists. Another exciting development was the introduction of the Corpath 200, a robotic system for percutaneous coronary interventions, which means that procedures can now be performed safely from a lead-lined cockpit using simple touch-screen and joystick controls.
Gene therapy hit a major milestone in 2012 when Glybera was approved by European authorities for the treatment of autosomal recessive lipoprotein lipase (LPL) deficiency. Gene therapy has been a promise in the making for decades, and as such, hopes are high for Glybera. Two other drugs had been approved several years ago in China as gene therapies for cancer, but with only very limited clinical success. We also had an early look at ongoing work to genetically reprogram cardiac cells to form a natural pacemaker. Meanwhile, genetic sequencing costs keep plummeting, and Life Sciences is confident that with its Ion Proton DNA sequencer it will be able to sequence so fast and cheap that it was the first to enter X-Prize 100 over 100 $1000 Genomes Challenge.
The app stores are well filled with medical apps, yet new ones keep popping up every day. Two apps really stood out for their clinical potential: the first is Spirosmart, an app that turns your iPhone into a spirometer, with an accuracy within 5% of traditional measurements. The second is an app in the making that will be able to detect atrial fibrillation using the phone’s camera. For the visually impaired, a braille touchscreen typing app was unveiled that might make their daily life easier. We reviewed a bunch of apps, including the New England Journal of Medicine app, Cardiio and the updated Medscape app. Furthermore we provided you with interviews with the people behind Visible Body’s Skeleton app, Pocket Anatomy, and BodyMaps.
Smartphone connected devices
Smartphone and tablets are increasingly used as hubs for medical devices to connect to. Whether you need heavy number-crunching, connectivity, or just a pretty display and a friendly user interface, mobile devices provide them at a fraction of the cost of developing custom solutions. One of the most prominent was the FDA approval of AliveCor’s ECG iPhone case, while Telcare introduced an app that connects to glucose meters even if they are oceans apart. A more generic solution is LGTmedical’s Vital Signs DSP, a platform for all kinds of sensors to connect to mobile devices. One manufacturer went further than just connecting to a phone, and created a phone itself packed with medical sensors. The Android-based Lifewatch V is able to obtain a one-lead ECG, measure body temperature, blood glucose, heart rate, blood oxygen saturation, body fat percentage and stress levels as expressed by heart rate variability.
Fitness tracking and quantified self
Self-tracking and the quantified self movement were going strong in 2012. Fitbit introduced a bunch of new devices and we had a closer look at the Fitbit Zip and One, and also at their Aria smart wireless scale. Nike released the Fuelband activity monitor, and introduced an accelerator program hoping to lure companies into its Nike+ technology platform. The hipsters will be glad when Misfit Wearables’ Shine becomes available for purchase in the coming year. And if you want to go beyond the usual activity tracking, Masimo offers a full-fledged pulse oximeter aimed at consumers that connects to iPhones and iPads.
Although discussion about open access to medical research results has been ongoing for a few years, 2012 could be the year that the foundation for a big shake-up were laid. In June, PeerJ launched a platform and journal for medical publications that promises lifetime open-access publishing for a one-time $99 fee per author, provided that you contribute by reviewing at least one paper a year. Then just recently we learned about Cureus, launched about the same time, which provides the same services, but with no charge for authors or readers whatsoever, instead relying on advertising revenue for its earnings. Both look very attractive at first sight if you compare them to the behemoth of open-access publishing, PloS One, which still charges $1350 for publishing one manuscript.
Some of the covered devices and technologies really stood out for their innovativeness or simplicity. The SRS Endoscopic System has the potential to turn an operation for gastroesophageal reflux disease into a minimally invasive procedure with exactly the same end-result. The AutoRIC employs a novel concept called remote ischemic conditioning for protection against ischemia-reperfusion injury. In addition, we saw the development of a 3D visualization method for microscopic histopathological specimens, the first complete virtual model of an organism and the FDA approval of the first subcutaneous ICD. On the electronics front, there were flexible as well as dissolvable electronics, and an ear implant that harvests energy from the body to power itself. Another first was the implantation of vestibular implants into humans.
Fun and plain weird stuff
Apart from all the great new devices, we also saw some fun or sometimes plain weird stuff. One exciting moment was the Red Bull Stratos jump, and we had an extensive look into the medical technology involved. In the category weird devices, one of the most popular posts on Medgadget this year was of an automatic sperm extractor, and in Japan you can now have a 3D print of your unborn fetus.
That is it for 2012, and we hope to see you back in 2013 with more exciting medical technology and science. Happy New Year to all!