Medical devices aimed at patients with corneal blindness, heart failure, and neurological weakness or paralysis have come under the spotlight in newly-published NICE briefings.
NICE Medtech Innovation Briefings aim to support NHS and social care commissioners and staff who are considering using new medical devices and other medical or diagnostic technologies. The information provided includes a description of the technology, how it’s used. and its potential role in the treatment pathway.
They also include a review of relevant published evidence and the likely costs of using the technology, but they are not NICE guidance and do not make any recommendations on the value of using the technologies. Whether or not to use the products described is entirely the choice of local staff.
However, the briefings will help avoid the need for organisations to produce similar information, so saving staff time, effort and resources.
The latest Medtech Innovation Briefings to be published are:
- Boston Keratoprosthesis Type 1 for Corneal Blindness: This is an artificial cornea used to provide a transparent optical pathway into the eye of people with corneal blindness, in whom corneal transplant may not be suitable. When fully assembled, the Boston KPro 1 device has the shape of a collar button and the front plate acts like a lens. The central portion of the person's opaque cornea is removed, and if the natural lens is in place, it is also removed. The prosthesis is then transferred to the person's corneal opening and secured as in standard transplantation. After the procedure, a soft contact lens is applied to the surface and worn permanently. It can restore sight for several years
- CentriMag for heart failure (Thoratec): CentriMag is CentriMag is an external blood pump, connected to a surgically-inserted cannula providing a ventricular assist device for short term cardiopulmonary support in people with heart failure. The smaller version for children is called PediVAS. It comprises a reusable motor, a console, a flow probe and a single-use centrifugal blood pump and circuit. The circuit has an inflow and an outflow cannula, which are both inserted through a cut in the upper abdomen and surgically connected to the heart. These cannulae are then connected to the external pump, which sits in the motor and is connected to the console. A flow probe is used to measure the blood flow. The external parts of CentriMag sit on a trolley, next to the patient. The motor magnetically levitates the rotor and operates without mechanical bearings or seals. This minimises friction, wear and heat generation, which may reduce the risk of blood-related complications.
- Ekso exoskeleton for rehabilitation in people with neurological weakness or paralysis (Ekso Bionics):This is a motorised orthosis device for use in rehabilitation activities for people who have weak or paralysed legs and sufficient arm strength to use crutches. It is intended to help people to relearn to stand and walk. It consists of an exoskeleton frame for the legs, passive ankle joints, a foot plate and an electric motor. There is also a backpack that contains a computer, battery and a wired controller. The exoskeleton is attached to the body by a series of straps set at a specific distance to ensure stability according to the patient's weight. Ekso incorporates proprietary SmartAssist software, which allows the physiotherapist to set the power for each leg independently to best suit the user
NICE Medtech Innovation Briefings are commissioned by NHS England and produced in support of the NHS 5 Year Forward View, specifically as one of a number of steps that will accelerate innovation in new treatments and diagnostics.