Archives: 7/2008

35234aaa1 Endurant Stent Graft System For Tortuous AortasMedtronic has announced its plans to start global marketing, pretty much everywhere except for the US, the company’s next generation endovascular AAA device, the Endurant Abdominal Stent Graft System. The device was recently given EU’s CE Mark of approval. The United States will likely be next, as the company is also announcing the first Endurant implants in a U.S. clinical trial.

The Endurant Stent Graft was CE (Conformité Européene) marked last week, and Medtronic will begin commercialization in mid-July. (CE mark is the European regulatory approval.) Outside the United States, the Endurant System expands the applicability of endovascular aortic repair (EVAR) to more patients with abdominal aortic aneurysms (AAAs), which are present in an estimated 1.2 million people and responsible for 15,000 deaths annually in the United States.
Building on more than a decade of industry-leading experience, the new device seeks to address those AAA patients whose aortas are highly angulated or whose aneurysms have short necks. Patients with these complex anatomies would previously have had no choice but watchful waiting or open surgical repair, in which the abdomen is opened and major organs temporarily moved in order to access the aorta. The Endurant Stent Graft System is an investigational device in the United States, where it is limited to investigational use only.
Prof. Hence Verhagen, chief of vascular surgery at the Erasmus Medical Center in Rotterdam, the Netherlands, led the European clinical trial of the Endurant Stent Graft System which supported the CE mark: “This next-generation device has performed exceptionally well in the treatment of abdominal aortic aneurysms. The Endurant System has the potential to expand the applicability of EVAR to more AAA patients who have been considered especially difficult to treat. I speak for my colleagues, too, by saying that physicians worldwide are eagerly awaiting the commercial release of this innovative new stent graft.”
The first implants of the Endurant Stent Graft System in the U.S. clinical trial took place during the last two weeks, with excellent periprocedural results. The initial implants at the Cleveland Clinic in Ohio were performed by Drs. Matthew Eagleton, Timur Sarac and Vikram Kashyap; those at Scott & White Memorial Hospital in Temple, Texas, were completed by a team led by Dr. C. J. Buckley.
Approved by the U.S. Food and Drug Administration in June under an investigational device exemption (IDE), the U.S. clinical trial of the Endurant Stent Graft System is designed to evaluate the device’s safety and effectiveness in the endovascular treatment of abdominal aortic aneurysms. As the pivotal trial for the Endurant Stent Graft, it will be used to seek FDA approval of the device. The study will enroll 150 patients at up to 30 U.S. sites in the next 12–18 months. All patients who meet the single-arm study’s inclusion criteria will receive an Endurant Stent Graft; their outcomes will be compared to those who received the Talent™ Abdominal Stent Graft as part of the pivotal study that led to that device’s FDA approval.

Press release: Medtronic Starts International Market Launch and U.S. Clinical Trial of Endurant Stent Graft…

465234ac Health 2.0 Accelerator
World’s foremost popularizer of Health 2.0 (vs Health 3.0 or Health 4.0; we tend to think of ourselves as a Health 4.0 enterprise), Mr. Matthew Holt tells Medgadget:

For several months there has been discussion amongst Health 2.0 companies about the concept of a Health 2.0 Accelerator. It started with Marty Tenenbaum’s introduction of the concept in September 2007. It continued with the discussion at the San Diego meeting in March 2008. Since then conversations and meetings among a small group have continued to define a first cut at what the Health 2.0 Accelerator should be.
The basic idea is for organizations to collaborate to create “public goods” — frameworks and strategies that will help all concerned to advance the industry. The way to do this is via projects that tackle particular problems, and leave behind frameworks and utilities that all can use.
The reality is of course going to be more complex, but we’re delighted to announce that the first project concerning moving pharmaceutical data has been announced, and the first principles and statements about the future of the Accelerator are now up at its own wiki at Health2Accelerator.org.
We are now asking for everyone in the Health 2.0 Community to become members, suggest projects, and contribute to the wiki. This is very much a work in progress, but we believe that the potential is huge.

Health 2.0 Accelerator…
Health 2.0 Accelerator – Technical Strategy…

Ac tive small Company Claims a Boost in IVF Rates with a New System
Ruskinn Technology of Sony Pencoed, South Wales was showing off its new Ac-tive® IVF system (Assisted Conception Total In Vitro Environment) at the European Society of Human Reproduction and Embryology annual meeting earlier this week. The company claims that their device results in higher conception rates.
From the press release, titled “New IVF “lab in a box” increases clinical pregnancy rates by 50%”:

The state-of-the-art gas controlled device mimics ‘inutero’ conditions for all IVF manipulations in a single workstation. According to Ruskinn, recent clinical trials in Denmark have demonstrated an increase in clinical pregnancy rates by up to 50% in an already successful IVF laboratory using the Ac-tive workstation.
According to the Human Fertilisation and Embryology Authority, the average IVF success rate (take home baby rate) for women under 35 years of age is 29.6%1. Using the Ac-tive IVF workstation, IVF clinics could potentially increase their “take home baby rate” by 50% – from a successful 29.6% to a possible 44.4%. Ac-tive results in the production of less stressed embryos, which suggests improved implantation in the uterus and ultimately increased pregnancy rates.
Replicating the entire in-utero environment in a single, controlled-atmosphere workstation, Ac-tive delivers a stable, optimal atmosphere which simulates the environment of the human body and creates optimal conditions for embryo
culture. This means all IVF procedures – from oocyte retrieval through to embryo transfer, and including embryo culture and selection – take place in a single, stable biological atmosphere.
The Ezee Sleeve™ Bare-hand System provides ‘hands in’ access to the workstation, enabling all processes to be carried out without disturbing the carefully controlled environment.

Press release (.pdf)…
Product page: Ac-tive® IVF System…

The Wall Street Journal is reporting on research at Yale that is being conducted to identify babies that have a high risk of developing autism in later years. The system tracks eye movement of the child when presented with images of people and things.
Here’s a video from WSJ with more details:


More at the Wall Street Journal

The concept of personalized pharmaceuticals, the design of which is based on one’s individual genome, is coming closer to reality. Deanna Kroetz from UCSF’s School of Pharmacy has an excellent overview of the whole business of pharmacogenetics. The lecture is one hour long and can be seen below:


(hat tip: The Medical Quack)

laser x220 Killing Cancer Cells One at a Time with Laser MicroscalpelResearchers at the University of Texas at Austin and Stanford University developed a “microscalpel”, an experimental system based on a super fast laser and something called “two-photon fluorescence microscopy”, to zap individual cells while preserving those around the target area.

To develop the miniature laser-surgery system, Ben-Yakar [Adela Ben-Yakar, mechanical engineering Assistant Professor at UT Austin --ed.] worked with co-author Olav Solgaard at Stanford University’s Electrical Engineering Department to incorporate a miniaturized scanning mirror. Ben-Yakar and her graduate student Chris Hoy, another co-author, also used a novel fiber optic cable that can withstand intense light pulses traveling from an infrared, femtosecond laser. To make the intensity more manageable, they stretched the light pulses into longer, weaker pulses for traveling through the fiber. Then they used the fiber’s unique properties to reconstruct the light into more intense, short light pulses before entering the tissue.
For the study, Ben-Yakar directed laser light at breast cancer cells in three-dimensional biostructures that mimic the optical properties of breast tissue. She has since studied laboratory-grown, layered cell structures that mimic skin tissue and other tissues.
Ben-Yakar is also investigating the use of nanoparticles to focus the light energy on targeted cells. In research published last year, she demonstrated that gold nanoparticles can function as nano-scale magnifying lenses, increasing the laser light reaching cells by at least an order of magnitude, or 10-fold.
“If we can consistently deliver nanoparticles to cancer cells or other tissue that we want to target, we would be able to remove hundreds of unwanted cells at once using a single femtosecond laser pulse,” Ben-Yakar says. “But we would still be keeping the healthy cells alive while photo-damaging just the cells we want, basically creating nanoscale holes in a tissue.”

Full story: Laser Surgery Probe Targets Individual Cancer Cells…
More from MIT Technology Review
Image: Adela Ben-Yakar (top), inventor of a new high-resolution laser microprobe, at work in her laboratory at the University of Texas at Austin. An image taken with the microprobe shows a breast-cancer cell embedded in collagen, before (middle) and after (bottom) it is destroyed by the probe.
Credit: University of Texas Engineering Public Affairs (top); Adela Ben-Yakar Group (middle and bottom)

hermark HERmark Breast Cancer Assay Is Now Available
Monogram Biosciences, Inc. out of South San Francisco is announcing availability of their assay for the detection of a particularly aggressive type of breast cancer that exhibits presence of the HER2 protein.
From a press release by the company:

ERmark is a proprietary diagnostic that accurately quantifies HER2 total protein levels and HER2 homodimerization in patients with breast cancer. HERmark is a CLIA-validated assay that is performed exclusively in Monogram’s CAP-certified clinical reference laboratory in South San Francisco. Robust, accurate, sensitive and reproducible measurements of HER2 status are reported to physicians with a turnaround time of 7 days.
With the accurate measurements provided by HERmark, it is expected that as many as 15-20% of patients determined by conventional technologies to be HER2- negative would be reclassified by HERmark.
Key advantages of the HERmark Breast Cancer Assay include:
– HERmark is highly sensitive and can detect HER2 at levels from 2,500 to over 1 million receptors per cell — 7 to 10 times more sensitive than IHC.
– HERmark provides a better measure of HER2 status by measuring the drug target — the HER2 protein and HER2 homodimers — rather than the HER2 gene.
– The HERmark report is simple to interpret and provides a specific quantitative measure of HER2 expression, a HER2 status of “positive”, “negative” or “equivocal” and indicates, relative to conventional measurements, how positive or how negative the patient is.
– Clinical studies demonstrate that HERmark is an accurate method for stratifying patients with metastatic breast cancer who are more likely to respond to Herceptin-containing therapy.

Press release: Monogram Announces Commercial Availability of the HERmark(TM) Breast Cancer Assay…
Product page: HERmark…

A new design developed by researchers at UCLA and the Los Angeles VA could make dialysis visits a thing of the past. Standard hemodialysis often requires renal failure patients to come into the hospital for length 4+ hour dialysis sessions. Peritoneal dialysis is able to be done at home and is bloodless, but it still requires the patient to commit a few hours everyday or at night.
The new design is meant to be worn around during daily activities, so that it mimics the function of real kidneys by filtering out a little bit of the body’s toxins at a time. The device also filters the spent dialysate, which makes the device waterless and decreases protein loss. The device can filter about 96 liters per day.
For those that think this is all too good to be true the researchers have already signed a licensing agreement with a Singapore-based company, which means we might actually see this dream machine on the market.
Read the press release here
Read the design article here (requires subscription)…

There will be no posts today thanks to a great deal of travel for some, and continuing recovery from the 4th of July weekend for the other editors.