Introducing ACES
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Automatic Continuous Effusion Shunt
The ACES is an innovative solution to help eliminate recurrent pleural effusions with a “breathing powered” pump. Implanted under the skin and between the ribs in a minimally invasive procedure, ACES may reduce infection risk and healthcare costs associated with the management of pleural effusions.
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Pleural Effusions
What is a Pleural Effusion?
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​Typically the result of advanced cancer or organ failure
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Excess fluid between lung and chest wall
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Fluid re-accumulates after drainage
What do they Do?
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Causes debilitating shortness of breath, discomfort, poor quality of life.
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Compresses the lung and weighs on the diaphragm
Current Treatment Options
Solutions for treating recurrent pleural effusions today are painful, burdensome and costly.
Pleurodesis:
Pleurodesis is a procedure that uses chemical sclerosing agents to obliterate the pleural space. It can offer a permanent solution but is a painful procedure that requires an extended hospital stay. It is not appropriate for up to 40% of patients .
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Indwelling Pleural Catheters (IPCs)
Indwelling Pleural Catheters (IPCs) are implanted catheters that have an externalized port to allow drainage of pleural effusions. This method requires regular drainage into expensive, single-use vacuum bottles, carries a high risk of infection, and often requires home healthcare assistance.
A Better Option for Recurrent Pleural Effusions:
ACES
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The ACES device uses the motion of normal breathing to automatically and continuously move effusion fluid from the pleural ‘lung’ space to the peritoneal ‘abdomen’ space where it is naturally reabsorbed by the body. With ACES, there is no need for pleurodesis and no need for an external drainage catheter.
Pump Chamber
Pleural Catheter
Peritoneal Catheter
ACES: Automatic Continuous Effusion Shunt (Patented)
ACES Placement
ACES is a fully implantable treatment. The pump chamber is placed under the skin between the ribs with one catheter in the pleural space and the other in the abdomen for drainage.
Intuitive Implant Procedure
The aces implant procedure is essentially the combination of two other regularly performed procedures and can be performed after modest training. Physicians have rated the procedure as “easy”.
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When performed as an inpatient, the procedure is covered by existing reimbursement codes
“The device works. It goes in, stays in, drains fluid, doesn’t clog, patients feel better, they don’t need bottles and they don’t need to come in for management… this thing is doing what its supposed to do.”
-Lonny Yarmus, DO
Baltimore, MD
The Potential to Improve Outcomes
ACES automatic continuous pleural effusion shunt is designed to provide continuous symptom relief:
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freeing patients from extended and often painful hospital stays
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eliminating the need for external catheters and the burden of home drainage
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giving physicians a new, minimally invasive treatment option
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improving healthcare economics for providers
Early ACES experience demonstrated up to a 94% reduction in pleural effusions.
ACES compares favorably to other treatment Options:
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Lui, Complications of indwelling pleural catheter use and their management, BMJ 2015
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Puri, Treatment of Malignant Pleural Effusion-A Cost-Effectiveness Analysis. Ann Thor Surg 2012
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Penz, Comparing Cost of Indwelling Pleural Catheter vs Talc Pleurodesis for Malignant Pleural Effusion. Chest 2014
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Estimates based on early patient experience, animal testing, thoracentesis and pleural catheter data
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Pleural catheters with vacuum bottle only provide relief after drainage. Pleural effusion symptoms recur between drainage.
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Dressler, Phase III Intergroup Study of Talc Poudrage vs Talc Slurry Sclerosis for Malignant Pleural Effusion, Chest 2005
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Taghizadeh, N., et. al, US Hospitalizations for MPE, Data from 2012 National Inpatient Sample, Chest 2016
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Davies, Effect of an Indwelling Pleural Catheter vs Chest Tube and Talc Pleurodesis for Relieving Dyspnea in Patients With Malignant Pleural Effusion: The TIME2 Randomized Controlled Trial, JAMA 2012
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Thomas, Effect of an Indwelling Pleural Catheter vs Talc Pleurodesis on Hospitalization Days in Patients With Malignant Pleural Effusion: The AMPLE Randomized Clinical Trial, JAMA 2017
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​Bhatnagar, Effect of Thoracoscopic Talc Poudrage vs Talc Slurry via Chest Tube on Pleurodesis Failure Rate Among Patients With Malignant Pleural Effusions A Randomized Clinical Trial, JAMA 2019
“Providing our patients with a solution that improves their quality of life and lessens the burden of maintaining an implanted medical device for their chronic medical condition has the potential to really change the way we manage pleural disease”
Dr. Jason Akulian, MD
Chapel Hill, NC