Clinical Evaluation of BackStop in Patients Undergoing Ureteroscopic Lithotripsy

NCT ID: NCT02122341

Last Updated: 2019-05-22

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2016-07-31

Brief Summary

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The purpose of this clinical study is to evaluate BackStop, a polymer-based device that is intended to be used during ureteroscopic lithotripsy to prevent retrograde stone migration.

Detailed Description

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During ureteroscopic treatment for ureteral stones, lithotripsy, irrigation, and manipulation of the stone often pushes stone away into the kidney itself. This phenomenon is called retropulsion, which is defined as clinically significant retrograde migration of stone or stone fragments. Movement of stones retrograde into the renal pelvis could potentially add and complicate the surgery further. Often scopes need to be changed in order to reach the stone, and chasing these stones will add time to the surgery and require more valuable resources. Furthermore, sometimes a second operation will need to be done when these retropulsed fragments could not be all found and cleaned out.

A number of devices have been developed to prevent such migration including stone baskets and conical devices. These are wire-based devices which have the potential of injuring the ureter. Because of safety concerns and that there is limited data available on the effectiveness of these devices; these are not widely used by urologists. BackStop has recently been developed as another tool to prevent retropulsion. It is a water soluble gel that is injected proximal to the stone. This creates a physical barrier that prevents stone migration during ureteroscopic lithotripsy for ureteral calculus.

Conditions

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Kidney Stones

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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BackStop

Patients randomized to the Experimental arm will receive the BackStop gel during their ureteroscopic lithotripsy to prevent retrograde migration of stones or stone fragments.

Group Type EXPERIMENTAL

BackStop

Intervention Type DEVICE

BackStop™ is a FDA approved device. It is intended for use during ureteroscopic lithotripsy to prevent retrograde migration of stones and stone fragments. It is comprised of a solution of a thermosensitive polymer, a purified version of poloxamer 407 having been fractionated in saline. BackStop™, which is injected above the stone, is provided in sterile, pre-filled 2.5ml and 5ml syringes along with and a corresponding injector and a catheter (3F or 5F).

Control

Patients randomized to the control group will not use any devices to prevent retrograde migration of stones and stone fragments during their ureteroscopic lithotripsy.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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BackStop

BackStop™ is a FDA approved device. It is intended for use during ureteroscopic lithotripsy to prevent retrograde migration of stones and stone fragments. It is comprised of a solution of a thermosensitive polymer, a purified version of poloxamer 407 having been fractionated in saline. BackStop™, which is injected above the stone, is provided in sterile, pre-filled 2.5ml and 5ml syringes along with and a corresponding injector and a catheter (3F or 5F).

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* patient with solitary ureteral stone ranging from 5mm to 15mm diameter
* able to tolerate general anesthesia
* clinical indication for treatment by ureteroscopic lithotripsy
* must be willing and able to participate in any follow-up visits
* provide informed consent
* have a CT scan demonstrating the stone

Exclusion Criteria

* patients undergoing extracorporeal shock wave lithotripsy (ESWL) or any other extracorporeal or percutaneous lithotripsy procedure as primary procedure
* any co-morbidity or condition that would necessitate exclusion of patient (physician opinion)
* renal or ureteral anatomical abnormality
* multiple stones in the indicated ureter
* stones in the indicated kidney
* patient is immunocompromised
* multiple organ dysfunction syndrome
* has an absolute or relative solitary kidney mass
* \>= Stage 3 chronic kidney disease
* bilateral ureteral obstructing stones
* staghorn calculi
* impaction of several stone fragments (Steinstrasse)
* uncorrected coagulopathy/thrombocytopenia
* urethral and/or ureteral stricture
* reconstructive urinary surgery
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Urology of Virginia

OTHER

Sponsor Role collaborator

University of Southern California

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Matthew Dunn, M.D.

Role: PRINCIPAL_INVESTIGATOR

USC Institute of Urology

Locations

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USC Institute of Urology

Los Angeles, California, United States

Site Status

Urology of Virginia

Virginia Beach, Virginia, United States

Site Status

Countries

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United States

References

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Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE, Macaluso JN Jr. Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. The American Urological Association. J Urol. 1997 Nov;158(5):1915-21. doi: 10.1016/s0022-5347(01)64173-9.

Reference Type BACKGROUND
PMID: 9334635 (View on PubMed)

International Conference on Harmonisation of technical requirements for registration of pharmaceuticals for human use.. ICH harmonized tripartite guideline: Guideline for Good Clinical Practice. J Postgrad Med. 2001 Jan-Mar;47(1):45-50. No abstract available.

Reference Type BACKGROUND
PMID: 11590294 (View on PubMed)

Hendrikx AJ, Strijbos WE, de Knijff DW, Kums JJ, Doesburg WH, Lemmens WA. Treatment for extended-mid and distal ureteral stones: SWL or ureteroscopy? Results of a multicenter study. J Endourol. 1999 Dec;13(10):727-33. doi: 10.1089/end.1999.13.727.

Reference Type BACKGROUND
PMID: 10646679 (View on PubMed)

Pardalidis NP, Kosmaoglou EV, Kapotis CG. Endoscopy vs. extracorporeal shockwave lithotripsy in the treatment of distal ureteral stones: ten years' experience. J Endourol. 1999 Apr;13(3):161-4. doi: 10.1089/end.1999.13.161.

Reference Type BACKGROUND
PMID: 10360494 (View on PubMed)

Chow GK, Patterson DE, Blute ML, Segura JW. Ureteroscopy: effect of technology and technique on clinical practice. J Urol. 2003 Jul;170(1):99-102. doi: 10.1097/01.ju.0000070883.44091.24.

Reference Type BACKGROUND
PMID: 12796655 (View on PubMed)

Knispel HH, Klan R, Heicappell R, Miller K. Pneumatic lithotripsy applied through deflected working channel of miniureteroscope: results in 143 patients. J Endourol. 1998 Dec;12(6):513-5. doi: 10.1089/end.1998.12.513.

Reference Type BACKGROUND
PMID: 9895254 (View on PubMed)

Robert M, Bennani A, Guiter J, Averous M, Grasset D. Treatment of 150 ureteric calculi with the Lithoclast. Eur Urol. 1994;26(3):212-5. doi: 10.1159/000475382.

Reference Type BACKGROUND
PMID: 7805707 (View on PubMed)

Rane A, Bradoo A, Rao P, Shivde S, Elhilali M, Anidjar M, Pace K, D'A Honey JR. The use of a novel reverse thermosensitive polymer to prevent ureteral stone retropulsion during intracorporeal lithotripsy: a randomized, controlled trial. J Urol. 2010 Apr;183(4):1417-21. doi: 10.1016/j.juro.2009.12.023. Epub 2010 Feb 20.

Reference Type BACKGROUND
PMID: 20171695 (View on PubMed)

Related Links

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http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/TextSearch.cfm

FDA MAUDE database online (accessed date July 8, 2007)

Other Identifiers

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HS-12-00714

Identifier Type: -

Identifier Source: org_study_id

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