Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
  • A61N1/00—Electrotherapy; Circuits therefor
  • A61N1/02—Details
  • A61N1/04—Electrodes
  • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
  • A61N1/0519—Endotracheal electrodes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
  • A61B5/316—Modalities, i.e. specific diagnostic methods
  • A61B5/389—Electromyography [EMG]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
  • A61B5/316—Modalities, i.e. specific diagnostic methods
  • A61B5/389—Electromyography [EMG]
  • A61B5/394—Electromyography [EMG] specially adapted for electroglottography or electropalatography
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
  • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
  • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
  • A61B5/6852—Catheters
  • A61B5/6853—Catheters with a balloon
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0402—Special features for tracheal tubes not otherwise provided for
  • A61M16/0404—Special features for tracheal tubes not otherwise provided for with means for selective or partial lung respiration
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0434—Cuffs
  • A61M16/0445—Special cuff forms, e.g. undulated
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0434—Cuffs
  • A61M16/0454—Redundant cuffs
  • A61M16/0459—Redundant cuffs one cuff behind another
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0486—Multi-lumen tracheal tubes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
  • A61B2560/04—Constructional details of apparatus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
  • A61B5/25—Bioelectric electrodes therefor
  • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
  • A61B5/296—Bioelectric electrodes therefor specially adapted for particular uses for electromyography [EMG]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0434—Cuffs
  • A61M16/044—External cuff pressure control or supply, e.g. synchronisation with respiration
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/04—Tracheal tubes
  • A61M16/0434—Cuffs
  • A61M16/0443—Special cuff-wall materials
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
  • A61M16/0816—Joints or connectors
  • A61M16/0833—T- or Y-type connectors, e.g. Y-piece
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
  • A61M39/08—Tubes; Storage means specially adapted therefor
  • A61M2039/082—Multi-lumen tubes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/02—General characteristics of the apparatus characterised by a particular materials
  • A61M2205/0216—Materials providing elastic properties, e.g. for facilitating deformation and avoid breaking
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/02—General characteristics of the apparatus characterised by a particular materials
  • A61M2205/0233—Conductive materials, e.g. antistatic coatings for spark prevention
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/13—General characteristics of the apparatus with means for the detection of operative contact with patient, e.g. lip sensor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/33—Controlling, regulating or measuring
  • A61M2205/3317—Electromagnetic, inductive or dielectric measuring means
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2210/00—Anatomical parts of the body
  • A61M2210/06—Head
  • A61M2210/0625—Mouth
  • A61M2210/065—Throat; Pharynx
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2230/00—Measuring parameters of the user
  • A61M2230/08—Other bio-electrical signals
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2230/00—Measuring parameters of the user
  • A61M2230/60—Muscle strain, i.e. measured on the user

Definitions

• Endobronchial tubes also known as dual-lumen endotracheal tubes
• Endobronchial tubes provide an open airway for patient ventilation during surgery.
• endobronchial tubes are used during surgical procedures to provide ventilation to individual lungs separately.
• Current endobronchial tubes include a first, tracheal lumen and a second, bronchial lumen.
• Each lumen includes an associated inflatable cuff, the cuff associated with the tracheal lumen being positioned within the trachea and the cuff associated with the bronchial lumen being positioned within one of the bronchus.
• the apparatus includes an endobronchial tube having an exterior surface and two lumens for providing ventilation.
• Conductive ink electrodes are formed on the exterior surface of the endobronchial tube.
• the conductive ink electrodes are configured to receive the EMG signals from the laryngeal muscles when the endotracheal tube is placed in a trachea of the patient.
• At least one conductor is coupled to the conductive ink electrodes and is configured to carry the EMG signals received by the conductive ink electrodes to a processing apparatus.
• FIG. 1 is a schematic view of an EMG endobronchial tube.
• FIGs. 2A and 2B are different side views of an endobronchial tube.
• Fig. 2C is a sectional view of the endobronchial tube illustrated in Fig.
• FIG. 3 is a partial side view of an endobronchial tube having an electrode cuff.
• FIG. 1 shows an EMG endobronchial tube 100 made from extruded polymer.
• Endobronchial tube 100 includes solid wires 102, a bronchial fitting 104, a tracheal fitting 106, a y-connector 108, a bronchial cuff inflating conduit 110, a tracheal cuff inflating conduit 112, extruded polymer tube 114, electrodes 116, bronchial cuff 120 and tracheal cuff 122.
• Solid wires 102 are connected to electrodes 116 at an interconnection 124.
• Tube 114 transports gases to and from the lungs.
• tube 114 defines a first, bronchial lumen 126 extending from bronchial fitting 104 to an opening 128 distal the bronchial cuff 120 and a second, tracheal lumen 130 extending from tracheal fitting 106 to an opening 132 distal the tracheal cuff 122.
• the Y-connector 108 fluidly couples the bronchial fitting 104 and tracheal fitting 106 to bronchial lumen 126 and tracheal lumen 130, respectively.
• Fittings 104 and 106 are configured to be connected to a respirating machine (not shown) for injecting air into the lungs and withdrawing air from the lungs.
• Cuff inflating conduits 110 and 112 are configured to be connected to a source of compressed air (not shown) for inflating cuffs 120 and 122.
• Cuff inflating conduit 110 communicates with a lumen located in the wall of tube 114, and the lumen communicates with bronchial cuff 120.
• tracheal cuff inflating conduit 112 communicates within a lumen located in the wall of tube 114, and the lumen communicates with tracheal cuff 122.
• one of the fittings is configured to inject air into one lung while the other fitting (e.g., tracheal fitting 106) is configured to injected air into the other lung.
• cuff 120 can be positioned into the left bronchus and cuff 122 positioned into the trachea.
• opening 126 is positioned to direct air into the left lung from bronchial fitting 104 while opening 132 is positioned to direct air into the right lung from tracheal fitting 106.
• air can be provided to only one of the fittings 104, 106 so as to provide air to only a single lung and collapsing the other lung.
• Electrodes 116 sense EMG signals, which are output to an EMG processing machine, such as nerve integrity monitor (NIM) device 140, via solid wires 102.
• NEM nerve integrity monitor
• Die cut tape may be used to tape tube 114 to a patient's mouth to secure the tube and keep it appropriately positioned.
• the NIM 140 is configured to determine when the electrodes 116 are in contact with the vocal folds, and is configured to provide an alert to the surgeon when such contact is lost. In one embodiment, the NIM 140 is also configured to determine whether the electrodes 116 are in contact with muscle or tissue based on the received signals
• tube 114 is a braided tube that is more flexible than conventional solid polymer tubes, and that reduces kinking.
• Tube 114 according to one embodiment is formed from a braided polymer or nitinol within a thin- walled tube, and reduces or eliminates rotation of the tube at the vocal folds, while allowing a proximal portion of the tube to rotate.
• Figure 2 A shows a first side view (posterior side) of endobronchial tube
• Figure 2B shows a second side view (rotated 90 degrees from the view shown in Figure 2A) of the endobronchial tube 114 shown in Figure 2A.
• Figure 2C is a diagram illustrating a cross-sectional view of the endobronchial tube 114 shown in Figures 2 A and 2B.
• Electrodes 116 include four electrodes 1 16A-116D, which are formed around a circumference of the tube 114 and extend in a longitudinal direction of the tube 114. Electrodes 116A and 116B are positioned entirely on the posterior side of the tube 114 and are also referred to herein as posterior electrodes 116A and 116B. Electrodes 116C and 116D are positioned entirely on the anterior side of the tube 114 and are also referred to as anterior electrodes 116C and 116D. The anterior side of the tube 114 is the bottom half of the tube 114 shown in Figure 2C, and the posterior side of the tube 114 is the top half of the tube 114 shown in Figure 2C.
• Each of the electrodes 116A-116D is coupled to a respective trace 150A-150D (trace 150D is not visible in the Figures). Traces 150A-150D are positioned in a protected (masked) region 152 of tube 114. Posterior electrodes 116A and 116B are positioned in an exposed (unmasked) region 154 of tube 114. Anterior electrodes 116C and 116D are positioned in an exposed (unmasked) region 156 of tube 114.
• each of the electrodes 116A-116D has a length of about one inch, and extends laterally around a circumference of the tube for a distance corresponding to an angle 160 of about 60 degrees (i.e., each of the electrodes 116A-116D has a width of about 16.67 percent of the total circumference of the tube).
• the electrodes are laterally spaced apart around the circumference of the tube by a distance corresponding to an angle 160 of about 30 degrees (i.e., the lateral spacing between each of the electrodes 116A-116D is about 8.333 percent of the total circumference of the tube).
• the posterior electrodes 116A and 116B are longitudinally offset or displaced from the anterior electrodes 116C and 116D.
• the posterior electrodes 116A and 116B are positioned closer to the distal end (right side in Figures 2A and 2B) of the tube 114 than the anterior electrodes 116C and 116D, and the anterior electrodes 116C and 116D are positioned closer to the proximal end (left side in Figures 2A and 2B) of the tube 114 than the posterior electrodes 116A and 116B.
• Tube 114 includes an overlap region 166 where a proximal portion of the posterior electrodes 116A and 116B longitudinally overlap with a distal portion of the anterior electrodes 116C and 116D.
• the electrodes 116 do not physically overlap each other since they are laterally offset from each other.
• the overlap region 166 is about 0.1 inches long, and the overall length from a proximal end of the anterior electrodes 116C and 1 16D to a distal end of the posterior electrodes 116A and 116B is about 1.9 inches.
• the overlap region 166 is about 0.2 inches long, and the overall length from a proximal end of the anterior electrodes 116C and 1 16D to a distal end of the posterior electrodes 116A and 116B is about 1.8 inches.
• Tube 114 is configured to be positioned such that the vocal folds of a patient are positioned in the overlap region 166.
• the posterior electrodes 116A and 116B are configured to be positioned primarily below the vocal folds
• the anterior electrodes 116C and 116D are configured to be positioned primarily above the vocal folds.
• electrodes 116A and 116C are used for a first EMG channel
• electrodes 116B and 116D are used for a second EMG channel.
• 112B, 112C and 112D are equal in length. This will allow the finish product to be placed with little concerns of rotational alignment.
• conduits 110 and 112 are formed in a thickness of the tube 114 to carry compressed air to bronchial cuff 120 and tracheal cuff 122, respectively. Additionally, inside tube 114 are formed bronchial lumen 126 and tracheal lumen 130. During use, one of the lumens 126 and 130 can be used to inject gases into a particular lung while the other lumen is sealed from injecting gases into the opposite lung.
• another embodiment includes an electrode cuff
• cuff 122 positioned proximal the tracheal cuff 122.
• cuff 122 is of a different shape than that illustrated in Figs. 1-2C.
• Other shapes for the cuffs 122 and 170 can be utilized.
• Electrodes 116 are applied directly to the electrode cuff 170 and are similar to that discussed above.
• Cuffs 122 and 170 are sized so as to both provide suitable sealing between the trachea and cuff 122 yet provide suitable compliance of electrode cuff 170 in contact with the vocal folds of a patient when inflated by pressurized fluid provided within inflating conduit 110.
• the tracheal cuff 122 Upon inflation, the tracheal cuff 122 has a larger diameter Dl than a diameter D2 of electrode cuff 170.
• the diameter D2 is selected to be approximately half the diameter Dl .
• Dl is about 20 millimeters, whereas D2 is about 9 millimeters.
• Dl is approximately 27 millimeters, whereas D2 is approximately 14 millimeters.
• a length LI of the cuff 170 is selected to be greater than a length L2 for cuff 122.
• the LI is approximately 1.875 inches.
• LI is in a range from approximately 1.5 inches to 2.5 inches.
• a ratio of DLL 1 is selected to be in a range from approximately 15: 100 to 30: 100.
• a compliance for cuff 170 is selected so as to prevent trauma due to cuff 170 contacting the vocal folds of the patient.
• the cuff 170 is formed of a semi-compliant balloon. The semi-compliant balloon will increase in diameter about 10 to 20 percent from a nominal pressure to a rated burst pressure for the balloon.
• cuff 170 is formed of a compliant balloon such that the balloon will increase in diameter from 20 to 200 percent from a nominal pressure to a rated burst pressure of the balloon.
• the cuff 170 is formed of a compliant material that has a greater compliance than a material selected for cuff 122.
• cuff 122 has a compliance defined as increasing in diameter about 20 to 200 percent from a nominal pressure to a rated burst pressure for the cuff 122.
• Inflating conduit 110 extends along the length of tube 114 to electrode cuff 170 and continues in extension to the tracheal cuff 122. Due to relative compliance of the cuffs 122 and 170, cuff 122 is configured to fluidly seal the trachea of a patient when positioned, whereas electrode cuff 170 inflates to contact the vocal folds of the patient so as to prevent trauma from occurring due to contact between the cuff 170 and the vocal folds. Furthermore, by selecting diameters Dl and D2 of cuffs 122 and 170, tension exerted on an exterior surface of each cuff is adjusted.
• thickness and diameter for cuffs 122 and 170 are selected such that cuff 122 will absorb pressure and reduce pressure on cuff 170.
• cuff 170 can conform to a shape of vocal folds and ensure sufficient electrical contact between the electrodes 112 and the vocal folds without causing irritation by exerting too much pressure on the vocal folds.

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• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
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• Animal Behavior & Ethology (AREA)
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• Anesthesiology (AREA)
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• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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• Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
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• 2013
  • 2013-11-27 EP EP13812262.7A patent/EP3079577A1/en not_active Ceased
  • 2013-11-27 WO PCT/US2013/072193 patent/WO2015080721A1/en active Application Filing
  • 2013-11-27 CA CA2893048A patent/CA2893048C/en active Active
  • 2013-11-27 AU AU2013406220A patent/AU2013406220B2/en not_active Ceased
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