PD28-03 EFFICACY AND SAFETY OF A MAGNETIC HYDROGEL FOR STONE FRAGMENT REMOVAL: AN IN VITRO AND IN VIVO STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD28-03 EFFICACY AND SAFETY OF A MAGNETIC HYDROGEL FOR STONE FRAGMENT REMOVAL: AN IN VITRO AND IN VIVO STUDY Daniel Massana Roquero, T. Jessie Ge, Grace H. Holton, Kathleen E. Mach, Zachary Kornberg, Ryan Sun, Simon Conti, Shan X. Wang, and joseph C. Liao Daniel Massana RoqueroDaniel Massana Roquero More articles by this author , T. Jessie GeT. Jessie Ge More articles by this author , Grace H. HoltonGrace H. Holton More articles by this author , Kathleen E. MachKathleen E. Mach More articles by this author , Zachary KornbergZachary Kornberg More articles by this author , Ryan SunRyan Sun More articles by this author , Simon ContiSimon Conti More articles by this author , Shan X. WangShan X. Wang More articles by this author , and joseph C. Liao joseph C. Liao More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003313.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroscopic laser lithotripsy is the standard treatment for kidney stones<2 cm. Following lithotripsy, fragments<3 mm are often left behind due to limitations of standard stone retrieval tools and time. Residual stone fragments that do not pass contribute to recurrence. We have developed MagSToNE, an integrated stone fragment removal system consisting of a magnetic hydrogel to coat and magnetize stone fragments and a magnetic wire for extraction. Here we compare MagSToNE with standard nitinol basket extraction in an in vitro model and assess the safety of the approach in vivo in a porcine model. METHODS: Stone fragments (15-30, < 3 mm) were loaded in an ex vivo kidney model to compare ureteroscopic removal time and efficiency using MagSToNE and a conventional basket. With APLAC approval MagSToNE was assessed in vivo in porcine models. Fragments were introduced endoscopically to the kidneys of female pigs under general anesthesia. Magnetic hydrogel components were injected via flexible ureteroscopy, and magnetized stones were captured with a magnetic wire inserted through the working channel of the ureteroscope. Pigs were immediately euthanized or monitored for up to 72 hours post-procedure. Blood was collected at regular intervals, starting at hydrogel injection, for complete blood count (CBC) and metabolic panels. After nephrectomy, kidneys were bivalved for gross examination and processed for histology. RESULTS: In the in vitro model, we found that MagSToNE provided a faster (up to 57 %) and more efficient approach for extraction of kidney stone fragments than conventional basketing. Further, we demonstrated the feasibility of MagSToNE in in vivo porcine models. The injection catheter and magnetic wire (1 mm diameter) showed excellent compatibility with a disposable clinical ureteroscope, and magnetized fragments were removed through the ureteral access sheath. Initial results from in vivo MagSToNE application indicate that the hydrogel and extraction method are safe as no significant changes in vitals, blood count, or metabolic serum chemistries were observed in the porcine models. Visual inspection of the bivalved kidneys post procedure confirmed the absence of visible hydrogel. Survival studies in the porcine model are ongoing to further assess the safety of MagSToNE. CONCLUSIONS: MagSToNE is a promising approach to render patients stone free during ureteroscopy. We demonstrated that MagSToNE is superior to basketing in model systems, and we applied our technology in vivo to demonstrate the safe magnetic extraction of kidney stone fragments. Source of Funding: NIH R21DK131776 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e819 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Massana Roquero More articles by this author T. Jessie Ge More articles by this author Grace H. Holton More articles by this author Kathleen E. Mach More articles by this author Zachary Kornberg More articles by this author Ryan Sun More articles by this author Simon Conti More articles by this author Shan X. Wang More articles by this author joseph C. Liao More articles by this author Expand All Advertisement PDF downloadLoading ...