The Cleveland Clinic (clevelandclinic.com/innovations) unveiled its annual list of breakthrough devices and therapies at this year's Medical Innovation Summit. The list was assembled by a panel of Cleveland Clinic physicians and scientists, and assistance from consulting firm AlixPartners LLP. “These innovations represent technologies which may have a major impact in clinical practice in the near future,” said Tomislav Mihaljevic who headed the selection team. “We believe the list represents the best innovative approaches in health care today.”

In ascending order, the top 10 medical innovations for 2008 are:

  1. Dual-energy-source computed tomography features two X-ray sources and two detectors to image patients more quickly and with less radiation. The dual-source scanner's speed lets physicians look inside patients with high or irregular heart rates, once a significant limitation of CT scanners.

  2. Engineered cartilage products for repairing joints. Biologic and engineering principles will be used to design natural biomaterials that are surgically implanted into joints to restore cartilage damaged by injury or arthritis. It is much less costly and invasive than replacing the joint.

  3. Implanted neural devices let severely disabled control equipment. Novel communication interfaces are being developed to control devices and potentially restore limb movements to individuals with spinal cord injuries, stroke, ALS, as well as other nervous system injuries. This interface system will restore use for severely motor-impaired individuals.

  4. Image fusion for diagnostics and therapeutics will diagnose small medical problems and assist with minimally invasive procedures, such as stent placement and tumor ablation.

  5. Live attenuated influenza vaccine for children as young as six months. Nasal drops containing live attenuated flu can be used as a vaccine in lieu of injections, and protection against influenza for high-risk children.

  6. Oral anticoagulant drugs treat and prevent thrombosis. Newer anticoagulant treatments, including low molecular-weight heparins, are being introduced to curb complications such as bleeding and thrombosis.

  7. Combination of advances in information technology and genome scanning will support clinical applications. Genetic testing can assist with personalized risk assessments and disease management plans for a variety of genetically caused diseases.

  8. RNA-based therapeutics will treat patients unable to reach their targeted cholesterol levels with statins alone or who are statin intolerant. The therapy is intended to reduce the production of ApoB-100, a protein that carries certain forms of cholesterol and triglycerides in the bloodstream.

  9. Percutaneous aortic heart valves for high-risk patients. Surgeons will insert a new balloon-expandable wire-mesh valve with internal leaflets. The valve is inserted through a small incision in the groin or chest and fed through a catheter into position with X-ray screening. The balloon inflates to secure the valve.

  10. Flexible intra-luminal robotics. This catheter-based technology remotely manipulates devices within the intra-luminal space with precision and reproducibility. It surpasses human capabilities.