LifeVac LLC, a Massapequa man’s startup that sells an anti-choking tool, has signed an agreement with a distributor to market the plunger-like devices in more than a dozen countries.

Bulgaria-based EDM Ltd. will represent LifeVac in Greece, Cyprus, Albania, Bulgaria, Croatia, Slovenia, Kosovo, Turkey, Romania, Serbia, Montenegro, Bosnia and Herzegovina, Russia, Ukraine, Italy, Egypt and the former Yugoslav Republic of Macedonia.

Arthur Lih, 51, started LifeVac in his garage after selling his airfreight company in 2012. Last summer the company moved its offices from Farmingdale to Springfield Gardens, Queens, though the devices continue to be made under contract by Aztec Tool Co. Inc. in Edgewood.

Lih said the company is gradually getting traction.

July, he said, was the company’s “best month,” with sales of $15,000.

According to Injury Facts 2016, an annual statistical roundup published by the National Safety Council, choking is the fourth leading cause of unintentional death, with 4,864 Americans dying from choking in 2013.

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Lih is targeting populations deemed most in jeopardy of choking, such as those with cerebral palsy and Huntington’s disease, as well as institutions such as schools, hospitals and fire stations.

Lih said one recent sale went to Cerebral Palsy of Nassau County, which bought 140 units for care homes, buses and other facilities. LifeVac also has sold its devices to the Lindenhurst school district.

Earlier this year, the American Journal of Emergency Medicine published a study of the LifeVac using a cadaver and simulated airway obstructions made of clay. The study found the device was “clinically effective” on completely obstructed airways. The device works by suctioning material out of the airway.

The American Red Cross protocol for choking victims calls for calling 911 and striking the victim several times in the back between the shoulder blades. If that doesn’t clear the airway, the Red Cross recommends alternating “abdominal thrusts” with back blows.