As we look back on the medtech developments of 2015 there’s definitely a sense that we’re living through revolutionary times. Nearly every day exciting and fascinating technologies are being unveiled by small and large companies, universities, and even tiny independent groups. Empowered by high-powered computers, 3D printers, and other technologies, researchers, scientists, and engineers are coming up with novel solutions to age-old medical problems. Everything from treating gunshot wounds to how fetuses inside the womb are monitored is going through change thanks to technologies developed by thousands of independent minds around the world.
And so we’d like to take you on a quick tour of amazing, inspiring, and long hoped for medical capabilities that have graced these pages over the last year.
Eyes-On Wearable Ultrasound and Infrared Glasses
Who would have thought we’d have hands-free and at-a-distance ultrasound technology in a pair of glasses? Evena Medical released their Eyes-On device that projects both ultrasound waves and infrared light to visualize both the peripheral and deeper vasculature for venipuncture procedures. The glasses feature Epson’s Moverio technology that displays an image laid over the wearer’s field of view. The computer that powers the glasses does image processing on the imaging data, detecting the vasculature and displaying it over the patient’s skin within the glasses.
Here’s what you would see wearing the glasses when imaging the peripheral vasculature using infrared:
Nanoparticles and Vascular Stents for Busting Brain Clots
The field of nanomedicine has seen considerable progress this year in attacking its main target, cancer, but also in addressing other difficult conditions. Researchers at Harvard’s Wyss Institute and University of Massachusetts’ New England Center for Stroke Research combined a narrow stent with pressure activated nanoparticles to break up vessel occlusions in the brain that cause ischemic strokes. The technology addresses many cases for which clot retrieval is not appropriate and may prevent smaller pieces of the clot from causing damage further down the vasculature.
The stent is used to bore through the clot, creating a passage for a narrow stream of blood to flow through. Special nanoparticles carrying clot busting drugs are then released toward the clot. Designed to let go of their payloads when put under high pressure, the nanoparticles only become active when passing through the freshly made tunnel within the clot. Since the drug is released just near the clot, it sticks to it and dissolves it. Any pieces of the clot breaking away should also get a few of the millions of nanoparticles passing through attached to them, helping to break up any loose bits that may otherwise cause further damage.
Paralyzed People Walk Again!
Last year we’ve seen real progress toward getting paralyzed folks back up on their feet again, and not by simply using exoskeletons. At UCLA researchers managed to non-invasively stimulate the spinal cords of paralyzed men who were then able to voluntarily move their legs. Though they weren’t exactly walking and remained horizontal, one man out of the study went on with specialized rehab to be able to use a smart exoskeleton.
The UCLA researchers combined non-invasive spinal cord stimulation from NeuroRecovery Technologies with a powered exoskeleton from EKSO Bionics. The combination allowed the man to actually walk again, using his legs to push forward and take repeated steps while being supported by the exoskeleton.
Coincidentally, last year we got a chance to visit EKSO’s research lab and try out an exoskeleton for ourselves. Though the new prototype device we tried was designed for able bodied people operating heavy handheld equipment, the trip allowed us to experience the potential of exoskeletons for medical applications.
XStat
Can the same device make it to our “Best Of” list two years in a row? If it’s the XStat Rapid Hemostasis System, indeed it can. While originally developed for battlefield medics to stop bleeding from gunshot wounds, only this month has it been approved by the FDA for civilian use.
The XStat is a syringe filled with tablets made of an absorbent material. It’s inserted into the wound and the sponge tablets that are pushed inside rapidly swell on contact with blood. Since their new volume is many times their original size, the soaked sponges end up filling the space of the wound, preventing further bleeding. Once the patient is delivered to the hospital and treated, X-rays can be used to make sure all the sponges are removed since they all have a small radiopaque marker within them.
Fetal Pacemaker
While adult pacemakers are getting tiny, some patients may benefit considerably more from pacemaker miniaturization. Children born with complete heart block, a condition in which electrical signals don’t propagate properly throughout the heart, often don’t make it before a pacemaker can be implanted. Moreover, external pacemakers that are often used can come with serious side effects.
A team from Children’s Hospital Los Angeles and University of Southern California built and tested a pacemaker that can be implanted in utero into a fetus. Because the procedure can be done before birth and the pacemaker fully implanted into the child, we may soon witness complete heart block turn into a considerably less grave of a condition.
The device has already been tested with great success on sheep fetuses and the team behind the new pacemaker believes it’s ready for clinical trials. These should commence soon since the device is already covered by the FDA’s Humanitarian Use Device designation.
Light Powered Cardiac Pacemaker
Since we’re on the subject of pacemakers, we might be seeing the way they work fundamentally change. At Israel’s Technion-Institute of Technology researchers have been able to pace the rhythm of a rat’s heart using a beam of light. This was accomplished by using a virus to make the rat express the Channelrhodopsin-2 transgene within its ventricular myocardium. This made the rat heart react to blue light effectively the same as to an electric pacemaker, contracting along with flashes of the light. Since there aren’t any leads and the only device needed for pacing is a simple strobe light, the optogenetic technology may one day become common. One big next step to bringing light pacemakers closer to clinical practice is to figure out the optimal places within the heart where to express the transgene.
Check out this video of a rat heart beating to the rhythm of a light:
Light Producing Sleep Mask for Preventing Diabetic Retinopathy
Diabetic retinopathy is an unfortunate, but very common way for people with diabetes to lose their eyesight. It’s been a difficult to manage condition, but now there’s a new night-time sleep mask that may help dramatically slow its onset. As a patient’s diabetes progresses, the blood circulation worsens and the supply of oxygen to the retina is compromised. 
The retina is especially oxygen-starved at night since the rods, which are used primarily when the eyes dark-adjust, demand more oxygen than the light-activated cones. In response to this ischemia, the body signals for additional blood vessels to be formed in this region, but these new blood vessels are very weak and susceptible to microaneurysms and leaking. This leaking leads to retinal edema and eventually macular edema, which destroys a patient’s eyesight.
The Noctura 400 sleep mask from PolyPhotonix prevents the patient’s eyes from dark-adapting while the patient is asleep. It continuously shines light at the user’s closed eyelid, but the color and brightness of this light was selected such that it prevents the rods from dark-adapting but does not stimulate the patient’s cones or other photoreceptive cells. This prevents the therapy from adversely affecting the patient’s quality of sleep.
EarLens Laser-based Hearing Device
This year we also saw an FDA approval of the laser-based hearing aid from EarLens Corporation. The EarLens consists of two parts: a tympanic membrane transducer, which is non-surgically placed deep into the ear canal on the eardrum, and a behind-the-ear audio processor that is connected to a probe that’s placed in the ear canal. Sounds are converted to electronic signals, digitally processed, amplified, and sent to the ear tip, which contains a laser diode sending out pulses of light. A photodetector in the tympanic membrane transducer converts the light back into electronic signals, transmitting sound vibrations directly to the eardrum by direct contact. Check out how this ingenious device works:
WiSE Wireless Technology for LV Heart Pacing Without Coronary Sinus Leads
Pacemakers typically deliver electric signals only to the right side of the heart because that’s the easy route for lead placement. Now there’s a way for pacing both sides of the heart using a conventional pacemaker coupled with an additional system. The WiSE technolory from EBR Systems includes an implanted pulse generator near the heart and a receiver-electrode attached to the endocardium of the left ventricle.
The generator detects the signal of the primary pacemaker and fires off an ultrasonic pulse toward the receiver-electrode as needed. The tiny device converts sound waves into an electrical signal, pacing the left ventricle. One of the main advantages of the system is that it allows the physician to place the electrode anywhere within the heart, optimizing pacing therapy for each patient.
And there it is, 2015 is wrapping to a close, but on a high note. We are seeing revolutionary changes in how many diseases are managed, treated, and cured, and there’s a definite sense that things are only heating up. Genetic technologies, better approaches to pacing and stimulation, new materials and their applications, and many other aspects of how medicine can be improved will paint the pages of Medgadget in the coming years.
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