The Tissue Response to Implanted Active Medical Devices Meeting

Hyatt Dulles

Herndon, Virginia

May 9-10, 2014

CDTC Credential Program

The highly anticipated Certified Diabetes Technology Clinician (CDTC) credential program is finally here! Be one of the first clinicians to earn and add "C.D.T.C." to your résumé!

Why should I attend the Implanted Active Devices Meeting?

The goal of this meeting is to define the best technologies for developing biocompatible implanted active medical devices that will function accurately for longterm use without requiring servicing or replacement. This meeting will be critical to the field of implanted active medical devices because it will bring together experts from diverse disciplines to combine their knowledge for overcoming biocompatibility limitations of these systems. 

What are the objectives of the meeting?

The meeting objectives are to:

  1. Define the foreign body response related to implantation of a medical device;
  2. Discuss the factors that modulate the interaction of macrophages and foreign body giant cells on synthetic surface;
  3. Analyze promising approaches to overcome the challenges of the immune response which could improve safety, biocompatibility and function of a device; and
  4. Discuss opportunities for collaboration among biologists, immunologists, clinicians, bioengineers, and people from industry.

Questions that will be addressed at the meeting:

  1. How can biological-biomaterial interactions be minimized to promote implantation?
  2. How can the foreign body response be modified to allow greater duration of implantation?
  3. Can either the acute or the chronic inflammatory reactions to foreign bodies be decreased by modifying the surface or range of permitted micromotions of an implanted device?
  4. How can implanted sensors be designed to provide better performance through better data transmission and decreased power requirements?

    It is expected that this meeting will synthesize information from various engineering and biological disciplines to enhance the ability of sensor scientists and drug delivery engineers to answer these questions and to develop biocompatible sensors for physiological monitoring, and delivery of drugs or other treatments by way of implanted active devices.

How are implanted active medical devices being used?

Sensors and implanted drug delivery systems are known as active medical devices. These devices are being increasingly used for monitoring & treatment of diabetes as well as various neurologic, cardiac, orthopedic, & gastroenterology diseases. The development of more biocompatible devices is driving mHealth applications which depend upon wearable sensors & in some cases wearable effectors. Examples of these systems include the closed loop artificial pancreas, cardiac pacemakers & defibrillators, intra-articular sensors for monitoring replacement with artificial joints postoperatively, deep brain stimulators for pain relief, & gastric stimulators to induce satiety in obesity. Implanted active medical devices face a hostile environment in the body. These devices are frequently not biocompatible and are subject to various forms of foreign body rejection which impairs or eliminates their intended function. This workshop will be critical to the field of implanted active medical devices because it will bring together experts from diverse disciplines to combine their knowledge for overcoming biocompatibility limitations of these systems.

What are the benefits of better implanted sensors?

For diabetes, the lack of a viable longterm implantable glucose sensor and the requirement for frequent removal, site preparation, and reinsertion has hampered adoption of this potentially important method for monitoring glucose control. Cardiac implantable electronic sensors can measure heart rate derivatives, rhythm, thoracic impedance, ventricular filling pressure, cardiac output, and heart sounds. These sensors are currently being used for electrophysiological applications including pacing, antitachycardia therapies, cardiac resynchronization, and more recently also for outpatient monitoring of congestive heart failure. Deep brain or spinal cord neurologic stimulation with effectors is being used for movement disorders, seizure disorders, and intractable pain. Gastric stimulation has been applied to overeating associated with obesity, diabetic gastroparesis, and intractable nausea with vomiting. Implanted joint sensors to measure force, laxity, and range of motion are being used by orthopedists. Other emerging technologies include using sensors for measuring reflux in the esophagus, filling in the bladder, and prosthetic function in skeletal muscles. As sensors become smaller and less power-hungry, additional targets for monitoring are selected, and new uses for continuously monitored information are identified, then the problem of tissue interface with implanted sensors and effectors will become perceived as an increasingly problematic barrier to continuous monitoring and on-demand therapy adjustments.

How will the meeting educate and train young scientists and clinicians?

The meeting will present problems and solutions related to implanted active medical devices. The speakers will represent various physical and biological science disciplines. The interplay between clinicians and scientists will allow the scientists at the event to understand which problems the clinicians want to solve and the scientists will be exposed to currently available sensor and drug delivery systems that can be adapted to make better measurements and provide better treatments. A poster session will provide opportunities for interchanges between investigators, business people, and regulatory experts.