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According to the European Community, people suffering from conditions such as stroke, blindness, deafness, incontinence, glaucoma or hydrocephalus will be the first to benefit from a range of new technologies and implantable medical devices developed by a pioneering European consortium of researchers, surgeons and technology companies.
Half a century ago, Swedish scientists invented the first implantable heart pacemaker, demonstrating the potential of treating medical conditions by placing electronic devices within the human body. Now a consortium of 27 universities, research centres, hospitals, technology companies and manufacturers is developing new micro-technologies for implantable medical devices of the future.
The EU’s Healthy Aims project includes partners from seven EU
countries, Switzerland and Israel, all of whom were already members of
a medical devices industry association. ‘We started with a very strong
group of people,’ recalls Diana Hodgins of European Technology for
Business Ltd, the project coordinator. ‘We looked at the clinical needs
and the end manufacturers’ requirements and married those up to the
technologies that we had available.’
In its four years, the project has pioneered three powered implants and three diagnostic devices.
A common consequence of a stroke is that patients lose control of an
arm and are unable to release their grip. In functional electrical
stimulation (FES), muscles are activated by signals from an implant.
‘Our stimulator extends the wrist, so the hand is in the right
position, and then opens the fingers and thumb ready for an object to
be grasped,’ Hodgins explains.
‘The first ones have been implanted and we’ve had some excellent
results.’ The technology is now being extended to tackle incontinence
by helping patients control their bladder and bowel sphincter muscles.
A second product restores limited vision in certain types of blindness.
A camera chip integrated into a pair of glasses transmits data to an
array of electrodes inside the eyeball which stimulate retinal nerve
cells. The image has 231 points which is a major achievement for
patients with no sight at all. Clinical trials are already underway.
Similar technologies are being used in a cochlear implant to restore
hearing. Compared to existing devices, the implant will improve voice
recognition in noisy environments by having more stimulation sites and
placing them in the inner cochlea, sending electrical impulses directly
to the brain.
Yet another implant will measure the pressure inside the brain cavity,
a crucial diagnostic for sufferers of hydrocephalus where an excess of
fluid can damage the brain.
Three diagnostic tools are also emerging from the Healthy Aims project.
The glaucoma sensor, a contact lens incorporating a ‘strain gauge’ to
monitor the pressure within the eyeball, is already being trialled with
patients. A catheter for measuring the pressure inside the bladder will
help diagnose cases of incontinence. And an activity monitor, spun-off
from the FES work, will keep track of a person’s physical activity over
a period of time, in sport as well as in medicine.
All these products share a small number of core micro-technologies,
developed within the project, that will give the European medical
devices industry a toolkit of techniques for the future.
The first is wireless communication. All the implants and sensors
transmit and receive data without any connecting wires. Although a
single solution for all the devices has not proved practicable, the
project has developed a technology (based on the ‘medical implants
communications service,’ or MICS, standard) that can transmit radio
waves from an implant to a receiver worn on the body.
‘While it wasn’t suitable for all the applications, it’s the ideal
solution for FES,’ says Hodgins. ‘We now have a working MICS system
that can be sold anywhere in the world.’
The partners have developed arrays of tiny microelectrodes to stimulate
nerves or muscles and the connectors to join them to supporting
electronics. ‘Platinum electrodes are the most common for implantable
devices and the most difficult to make and join to in an automated
process. We’ve learned a great deal and we are now sharing that with
other projects,’ says Hodgins.
Implants have to last for the life of the patient. That means that they
must be completely enclosed by materials that will not degrade by long
exposure to body fluids. The team has come up with two new materials, a
modified silicone and diamond-like coating (DLC), both of which look
very promising.
Finally, implants need a source of power. At present, the only makers
of implantable batteries are in the USA and they do not sell their
technology to competitors. Now, thanks to Healthy Aims, two new
European prototypes are moving towards clinical trials: a rechargeable
battery, suitable for powering the FES and cochlear implants, and a
fuel cell powered by the body’s own glucose which could run a heart
pacemaker for ten years.
With several products only two to four years from certification, and
the MICS system and activity monitor even sooner, the project has given
a huge boost not just to the partners but to the European medical
devices sector as a whole.
‘We’ve actually surprised the Americans,’ says Hodgins who regularly
receives invitations to present the work of the consortium in
international conferences and journals.
‘They’re coming to us and saying ‘please tell us what you’re up to.’ On
all of these things, we’re leading the world. People will talk about
this project for a long time to come.’
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