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PATI ENT SAFE T Y


protective substances such as nitric oxide and prostacyclin, both of which reduce the risk of thrombosis.


Endothelial dysfunction occurs predominantly at sites of low shear stress, where the blood might be reduced or turbulent, which can lead to damage of endothelial cells and in turn can initiate inflammation and blood clotting. Whereas, regions of vasculature exposed to shear stress, where the blood flow is laminar (steady), are protected.


Mechanical compression devices, such as IPC or the Geko device are clinically proven to produce physiologically normal shear stress on endothelial cells. Devices like this provide an adjunct to drug therapy and are suitable when drug strategies may be impractical or contraindicated. They increase production and the release of anti-thrombotic, pro-fibrinolytic, vasodilation agents to stop clots.


The Geko device and its mechanism Prior to the pandemic, the device has been in routine use to treat and prevent a range of vascular and orthopaedic related conditions. Sky Medical Technology has proven, through a real-world study of over 1,000 patients, conducted in partnership with the NHS, that the Geko can prevent VTE. Immobile hyper-acute stroke patients had their contraindication or intolerance to IPC reviewed and quantified. The study showed that 68.8% of patients were in need of IPC but 29.5% of these patients were either contraindicated or were unable to tolerate this intervention, revealing a significant unmet need for an alternative anti-stasis (blood clot prevention) intervention. It is to this cohort the Geko device was fitted for unmet need.


The study measured VTE events at 90 days post-stroke. The data shows that the patients treated with IPC alone, as the standard of care, 2.4% suffered a VTE event, compared to a 0% incidence of VTE in patients prescribed the Geko device alone. Patients prescribed the device also showed no adverse events and reported a greater tolerance of the device compared to IPC. Furthermore, the solution provided an anti-stasis intervention where previously patients would have had no other intervention available to them (drugs following acute stroke are not recommended by NICE), ensuring no immobile stroke patient, with a high risk if VTE, was without a mechanical VTE prophylactic intervention. NICE guidance health economic analysis also shows that the Geko device is cost saving vs. the cost consequence of no VTE prophylaxis.


Moving forward


While many aspects of how this disease operates remain unknown, as clinicians around the world begin to find out more about COVID-19, it will be essential that they embrace new, innovative technologies and therapies to ensure that patients can receive the most effective standard of care in their recovery from this devastating condition. Studies exploring the Geko device anti- stats and endothelial function capabilities in hospitalised COVID-19 patients are being progressed and Sky Medical Technology is actively seeking further clinician engagement to collaboratively explore blood flow increase as part of the COVID-19 treatment strategies. The pandemic is without doubt the public health challenge of our time. The scale of the problem is unprecedented but is more than matched by the scale of the response and a spirit of partnership that is willing to embrace


50 l WWW.CLINICALSERVICESJOURNAL.COM


innovation – this brave new thinking is defining the new normal.


Reference 1 Varga, Z, et al. Endothelial cell infection and endotheliitis in COVID-19, The Lancet, Published: April 20, 2020DOI:https://doi.org/10.1016/S0140- 6736(20)30937-5


CSJ


Bernard Ross


Bernard Ross is the founder and CEO of Sky Medical Technology, which develops bioelectronic devices integrated with OnPulse neuromodulation technology to prevent and treat a wide range of acute and chronic circulatory conditions. He has over 20 years of senior experience at private and public board level across multiple industries including pharmaceutical, technology development and FMCG.


SEPTEMBER 2020


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