Our objective is to bring the DVSAD to the point that it can be licensed to a third party for commercialisation. The 3 main phases in this trajectory would be prototyping/Intellectual Property (IP), preclinical and clinical testing. The prototyping and IP phases have been covered in the initial StarTT-project. Evaluation and refinement of the prototypes have been the subject of the Advanced-project. This first evaluation led to several new insights and revealed some new design requirements to enable a stable implantation and to reduce the risk of distal shunt obstruction by clot formation. Some adaptations to the prototype were already made and tested in the animal trial. Other adaptations are currently in the prototyping phase.