Which Medical Device Discusses Some of the Products on Show at CIRSE 2013
Published date : 02 October 2013
Article date : 02 October 2013
Dr Phil Haslam, Editor-in-Chief for Which Medical Device attended CIRSE 2013. Here, he highlights a number of interesting devices that were on show during the 5-day congress.
CIRSE 2013 was held in the stunning city of Barcelona. The meeting seems to go from strength to strength with both an excellent scientific program and a superb trade exhibition. Once again I and some of my fellow editors from Which Medical Device spent some time in the exhibition hall browsing the stands for devices that were ether new to the market or novel. The following really struck us as worth a mention.
Magellan (Hansen Medical)
Hansen Medical have introduced robotics to IR with the Magellan. This device allows the radiologist to perform angiographic intervention remote from the patient and of course any radiation exposure. It allows precise control of a guiding catheter, catheter and guide wire simultaneously in all planes at the touch of a few buttons and by twiddling a few knobs. Yes it is that easy, as I found out.
The robot controls the advancement, angle and rotation of the guiding catheter and also of the catheter and wire. The operator switches between these by pressing a selection button. Also the technology exists to track catheter tips in 3D space which can be registered with a CT angio volume acquisition. The next logical step is to automatically guide the catheter tip through this volume using the robot. I guess then we will all be looking for a new job! This device is still in its early stages but has been proved viable in clinical cases. I can envisage that a lot of our IR will be performed with devices like this within the next 10 years.
Covidien Microwave Ablation Device
Covidien had an elegant demonstration of their new microwave ablation device which they claim is not significantly affected by cooling from vessels in close proximity to the tumour. They say that smaller vessels will be destroyed within the tumour and tumour cells adjacent to larger vessels will also be destroyed but the vessels preserved. I await clinical results with interest. Could this be a rival to IRE (irreversible electroporation)?
Ultrasound Guided Plexus (Pajunk Medical)
I came across what must be the most ultrasound visible needle known, manufactured by a German company Pajunk Medical. The needles have special angular indentations ‘cornerstone’ reflectors near their tips which will reflect ultrasound independent of the angle of insonation. I tried this out using one of their needles and a rival needle in a large piece of meat. This seemed very convincing to me.
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P64 Flow Modulation Device (Phenox)
Phenox demonstrated to me the P64 flow modulation device which seemed to be primarily aimed at neuro use, but of course could be used elsewhere. This is an extremely fine meshed stent that could be placed across the neck of a small aneurysm. The flow dynamics are sufficiently changed to allow thrombosis of the aneurysm. I think the mechanism is similar to the MARS stent and it possibly would also maintain patency of side branches covered by the stent. The device is deployed through a micro catheter and goes up to 6mm in diameter. It is fully retrievable until released by pulling the detachment tubing.
AngioVac (AngioDynamics)
AngioVac, a large calibre device from AngioDynamics is designed to be inserted into the femoral vein and used to vacuum extract large volume thrombus from the venous circulation. It has a funnel shaped tip that balloon expands to occlude the vein its placed in. They say it can even be advanced into the pulmonary outflow trunk to extract large PE. It is designed to be used in conjunction with cardiac bypass to allow extracted blood to be returned to the vascular system via a large bore cannula in the internal jugular vein. The picture below shows it being demonstrated within a plastic model.
Ruby Coil Embolization System (Penumbra Peripheral)
Penumbra Peripheral were demonstrating a very useful embolization system. This is the Ruby coil which comes in lengths up to 60cm. The coil is detachable and comes in ‘framing’ and ‘fill’ formats and can be delivered through a micro catheter. This is a competitor to the Balt micro spirale coils (30cm), but I have yet to see the cost comparison.
V2 Renal Denervation System (Vessix Vascular/Boston Scientific)
Renal Denervation devices continue to have a high profile at the meeting. Boston Scientific has bought Vessix with the V2 renal denervation that uses bipolar electrodes (no grounding pad) to perform the ablation. This uses the lowest power of all the devices (1W) and seems to be the quickest at about 2 minutes total treatment time.
Arrow GPS Balloon Catheter (Teleflex Medical)
Teleflex Medical were showcasing their Arrow GPS balloon catheter. This is a novel angioplasty balloon with a switch built into the catheter hub/handle to allow injection of contrast media or other liquids without removing the guidewire. In this way you could angioplasty a lesion and then perform a check angiogram without removing the guidewire or moving the balloon. This is likely to reduce the risk of losing access and reduce procedure times. The balloon is semicompliant and 4cm in length. I think this will have real advantages with complex angioplasty and fistula work.
Zilver PTX (Cook Medical)
Cook presented their 4 year results for the Zilver PTX drug eluting stent. These look very encouraging. We managed to meet up with Andy Forster, EMEA Business Unit Manager, Peripheral Intervention with Cook to discuss these results (read the article here). Cook were celebrating with an interesting piece of art that was produced in the main entrance hall over 3 days during CIRSE.
