MP14-01 EVALUATION OF A NOVEL CYSTOSCOPIC CRYOCATHETER FOR THE IN SITU DESTRUCTION OF BLADDER CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP14-01 EVALUATION OF A NOVEL CYSTOSCOPIC CRYOCATHETER FOR THE IN SITU DESTRUCTION OF BLADDER CANCER Anthony Corcoran, Aaron Katz, Anthony Robilotto, Kristi Snyder, Kimberly Santucci, Robert VanBuskirk, John G. Baust, and John Baust Anthony CorcoranAnthony Corcoran More articles by this author , Aaron KatzAaron Katz More articles by this author , Anthony RobilottoAnthony Robilotto More articles by this author , Kristi SnyderKristi Snyder More articles by this author , Kimberly SantucciKimberly Santucci More articles by this author , Robert VanBuskirkRobert VanBuskirk More articles by this author , John G. BaustJohn G. Baust More articles by this author , and John BaustJohn Baust More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003234.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a pressing need for the development of new devices facilitating advanced minimally invasive approaches for the in situ treatment of bladder cancer (BC). To this end, a new cystoscopic compatible cryocatheter (UroAblate) has been developed. When paired with the novel Pressurized Subcooled Nitrogen (PSN) cryoconsole, the cryocatheter delivers ultracold ablative temperatures to a targeted tissue in a closed loop manner. In this study, we evaluated cryocatheter performance for its potential use for cystoscopic in situ ablation BC. METHODS: A ∼1 m cryocatheter with a distal 1.5 cm ablation tip (connected to PSN) was passed through the working channel of a Ambu cystoscope. A laparoscopic approach was also utilized to visualize the transmural extension of the ice propagation. Evaluations included a 37°C ultrasound gel model, tissue engineered BC model and a chronic porcine study (4 animals, 7 day survival) wherein 10 lesions/animal were created throughout the bladder (bladder wall, trigone region, UO and distal ureter). Performance assessment included ice ball size, isotherm profile and destruction area. Single and double 0.5, 1, 1.5 and 2 min freeze protocols were evaluated. RESULTS: Bench studies demonstrated the generation of a 1.6cm iceball and the penetration of the -20°C isotherm to 0.87 cm following 2 mins. Analysis of tissue destruction using a BC tumor model revealed the creation of a 350 mm3 and 448 mm3 ablated volume following a single or double 2 min freeze, respectively. Porcine studies demonstrated the consistent generation of transmural lesions following freezing (single or double) for ≥1.5 min regardless of tissue thickness (range: 0.4 cm to 1.2 cm). All animals were found to have good overall health (maintained weight, appetite, mobility, energy levels, etc.) through the recovery period. No significant deviations were noted in CBC and serum chemistry bloodwork with the exception of elevated Creatine Kinase levels. Importantly, no fistulas or bowel/bladder perforations were noted in any animals. CONCLUSIONS: This study demonstrated that the cryocatheter was able to rapidly and effectively freeze targeted tissue via a cystoscopic approach. The results showed the device was able to consistently ablate a >1 cm area using a single 2 minute freeze protocol across all models. Analysis of the ablation efficacy revealed ∼80% destruction within the overall frozen mass. Although further testing and refinement are needed, these studies demonstrated the potential of this new approach to provide a next-generation strategy for the treatment of BC. Source of Funding: National Institutes of Health National Cancer Institute Grant No. 1R43CA210761-01A1 awarded to CPSI Biotech © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e182 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anthony Corcoran More articles by this author Aaron Katz More articles by this author Anthony Robilotto More articles by this author Kristi Snyder More articles by this author Kimberly Santucci More articles by this author Robert VanBuskirk More articles by this author John G. Baust More articles by this author John Baust More articles by this author Expand All Advertisement PDF downloadLoading ...