Tuesday, June 13, 2017
Interesting Front End Research on Ischemic Stroke from the Medtech Conference via MedCityNews
Front End Research is important for innovation in any industry. It was once my job to look to expand my company's existing devices to various health conditions, and to identify technologies, health opportunities, etc. I enjoyed it the most, and I still look around for opportunities.
A stroke is an event that disturbs blood flow in the brain. There are three broad classifications of stroke:
1. Hemorrhagic Stroke
2. Ischemic Stroke
3. Transient Ischemic Stroke (TIA)
Transient Ischemic Stroke is when the flow of blood to the brain is blocked, due to a transient blood vessel blockage. Among the other two, Ischemic strokes account for about 87% of all strokes and Hemorrhagic Strokes, the remaining 13%. Ischemic Stroke occurs when a fatty deposit blocks the flow of blood to the brain. This may worsen by breaking off into smaller emboli and blocking smaller arteries further up the brain. Hemorrhagic strokes occur when when a blood vessel weakens and undergoes a rupture, leaking blood into the brain and applying pressure on the surrounding brain tissue.
As reported by MedCity News, it appears that experts at a conference were recommending that medical device companies look at endovascular treatment for stroke. They exemplified mechanical means as an example, such as the thrombectomy/emboloctomy devices, one seen from Stryker and stents, one example stated being that of a stent from Medtronic. A combination of urgent care in terms of pharmaceutical treatment and medical devices does make a compelling case, and you can read more in the attached article. I want to move on and express a few thoughts of my own on all this.
1. First, I have been aware of the mechanical abrasion devices, with cutesy names such as the "rotablator" and so on, essentially biocompatible drills, which were patented, and thus, many organizations had stayed away from following on, with weak patents, especially because they were rumored (mind you, mostly, just rumored) to not work as well as hoped. It is interesting to note that Stryker has a device along the same lines. I assume they have access to existing patents, or have filed new ones.
2. One of the problems with cutting through plaque is that you need a distal filter to capture the plaque, to prevent it from causing transient ischemic strokes, or other ischemic strokes and damaging parts of the brain by cutting off blood flow. Since the brain is second only to the heart in importance, the aorta pumps blood into the brain at really high velocities, so, though, embolic protection devices exist, they are limited by size, the geometry of the carotid artery and other vessels, the high velocity of blood and the fact that the patients have typically already experienced a stroke and are weak to endure much by way of surgical procedures.
3. In the business of dissolving plaques, pharmaceuticals and medical devices compete. Other than in drug eluting stents, the two industries are in opposition to each other. Of course, Doctors would like to prescribe their patients a combination of drugs and device-based procedures, if medical device companies are to succeed, they need partnerships with pharmaceutical companies, and strong evangelism from practitioners.
4. Newer possibilities such as nanotechnology and MEMS should not be ignored in the quest for physical solutions to ischemic stroke treatment. Drills and stents become tiring after a while, and it is my hope that a newer generation of medical device solutions will rise to the occasion.
Yes, there is a clear problem, in need of solutions, when it comes to follow on treatments with ischemic stroke. Challenges remain, and yet, the good news is that these challenges are really well known, and therefore, so are the solutions. Perhaps, newer medical devices can emerge, alongside pharma and become integrated into the Standard of Care.
1. The MedCity News Article: http://medcitynews.com/2017/06/medtech-startups-look-ishecmic-stroke-area-unmet-need/?rf=1
2. Image, Courtesy Pixabay: https://pixabay.com/en/brain-triunique-reptilian-limbic-2235831/#