The Memo: Tulyp Medical Brings Active Management to Limb Perfusion

Tulyp Medical is developing a pressure-guided limb-perfusion system designed to prevent procedure-associated acute limb ischemia by enabling clinicians to continuously monitor and regulate blood delivery to the affected limb. Initially focused on patients undergoing procedures involving femoral arterial access, including venoarterial extracorporeal membrane oxygenation (VA-ECMO) and other forms of mechanical circulatory support, Tulyp is seeking to shift limb perfusion from a passive, reactive practice to an actively managed therapy.

Origin Story

Tulyp Medical began with a problem its founders, a group of clinicians and cardiovascular-device experts, repeatedly encountered in practice. Femoral access devices introduced through the femoral artery can compromise blood flow to the lower limb, yet clinicians may not recognize inadequate perfusion until injury has already begun.

The founding premise was straightforward: rather than waiting for signs of a complication, clinicians should be able to actively measure and manage limb perfusion. That insight became the foundation for Tulyp’s pressure-guided limb-perfusion platform.

Steve joined the Paris-based company as CEO in 2026, bringing more than 25 years of experience across cardiovascular devices, mechanical circulatory support, and critical care. For Motes, who has spent much of his career helping build markets around technologies that change clinical practice, Tulyp presented a familiar kind of opportunity.

“I joined Tulyp because four things came together: a significant unmet clinical need, compelling clinician-founded technology, a deeply experienced cardiovascular team, and the opportunity to create an entirely new category of care,” Motes said. “Tulyp is that same kind of opportunity: moving limb perfusion from a passive, reactive approach to an actively managed therapy.”

While headquartered in France, Tulyp’s initial regulatory and commercial focus is the United States, where the company sees an opportunity to introduce the technology within high-acuity cardiovascular centers before pursuing broader international expansion.

The Current Landscape

Tulyp’s first clinical focus is patients undergoing procedures involving femoral arterial access, particularly VA-ECMO and other forms of mechanical circulatory support. In these procedures, the device occupying the femoral artery can reduce blood flow to the lower extremity and place the limb at risk of acute ischemia.

The consequences can be significant. “Acute limb ischemia can lead to additional interventions, prolonged hospitalization, permanent disability, amputation, and, in the most severe cases, death,” Motes explained. “Published literature has reported limb ischemia in roughly one in six patients receiving VA-ECMO, although incidence varies considerably by population, technique, and clinical definition.”

Yet the way clinicians address that risk remains largely passive.

Standard practice can involve placing a distal perfusion catheter connected to the arterial circuit to deliver blood downstream of the femoral access site. The limitation is that conventional systems do not continuously measure distal perfusion pressure or automatically adjust blood delivery to maintain a defined physiological target. Instead, clinicians rely on intermittent assessments and may be forced to respond after signs of inadequate perfusion have emerged.

For Tulyp, the opportunity is not simply to deliver blood to the limb. It is to make adequate perfusion something clinicians can continuously measure, target, and control.

Inside the Innovation

Tulyp is developing a closed-loop system that pairs continuous distal-pressure sensing with a compact pump designed to regulate blood delivery to the lower limb. A clinician establishes a pressure target, and the system continuously monitors limb conditions and adjusts perfusion to maintain that target.

That feedback loop is central to the company’s approach. Rather than adding a standalone catheter or pump to the procedure, Tulyp is developing an integrated system connecting sensing, therapy, and control.

“What sets Tulyp apart is the closed loop of sensing, therapy, and control,” Motes explained. “We are not adding another catheter or another pump; we are building a system designed to tell clinicians whether the limb is receiving adequate perfusion and to manage delivery against a measurable physiological target.”

The distinction is important. A conventional distal perfusion catheter can provide blood to the limb, but Tulyp’s system is intended to determine whether the resulting perfusion pressure is adequate and then adjust delivery accordingly.

“That is the difference between reactive rescue and proactive prevention, and it is the foundation for a new standard of care,” Motes said.

Although VA-ECMO and mechanical circulatory support represent the company’s initial clinical focus, Tulyp sees the underlying concept extending further. The platform could potentially be applied across other cardiovascular, vascular, orthopedic, and interventional procedures in which blood flow to the lower extremity is reduced or disrupted.

Progress and Milestones

Tulyp remains an investigational-stage company, and its system is not currently cleared for commercial use in any market. But the company has begun building the clinical and regulatory foundation for its approach.

Tulyp has completed nine first-in-human cases. According to Motes, there were no device-related serious adverse events in that initial clinical experience, and the system demonstrated statistically significant maintenance of pressure within the targeted range.

“It was an early study, and additional evidence is required, but it provided important clinical validation of the pressure-guided concept,” he said.

The company’s regulatory strategy has also evolved. Tulyp initially pursued the FDA’s 510(k) pathway, but the process indicated there was no appropriate predicate for the technology. The company is now working with the FDA on a De Novo pathway for what Motes describes as a new category of regional and arterial-perfusion devices.

Its immediate priorities include establishing regulatory clarity, completing the necessary product development and clinical work, and preparing for commercialization. To fund that next stage, Tulyp is raising a Series A intended to support regulatory execution, further product development, clinical evidence generation, and commercial readiness.

The company arrives at LSI Europe ’26 with early clinical evidence in hand, a defined regulatory direction, and a financing round structured around those next value-creation milestones. Tulyp will also attend LSI USA ’27 to build relationships with Series A investors, clinicians, and potential strategic partners.

The longer-term vision, however, extends beyond a single procedure or indication.

“Our ambition is larger than a single indication,” Motes said. “We believe pressure-guided limb perfusion can become the standard across the many procedures in which blood flow to the lower extremity is compromised.”

If Tulyp succeeds, the shift it is pursuing is a fundamental one: from delivering blood and hoping perfusion is adequate to continuously knowing whether it is, and actively managing it when it is not.

Join Us at LSI Europe ‘26

Motes has been selected to present at LSI Europe '26, September 28th–October 1st, before hundreds of global medical technology companies. Join us in welcoming him to the event in Barcelona, where he will share the latest updates on Tulyp’s technology and development.