TY  - EJOU
AU  - Klyde, Daniel M. 
AU  - Aro, Tareq 
AU  - Okeke, Zeph 
AU  - Hoenig, David M. 
AU  - Tano, Zachary E. 
AU  - Rai, Arun 
AU  - Winoker, Jared S. 

TI  - Real-world experience with steerable ureteroscopic renal evacuation using the second-generation CVAC system in a large multicenter institution
T2  - Canadian Journal of Urology

PY  - 
VL  - 
IS  - 
SN  - 1488-5581

AB  -  <b>Objectives:</b> The landscape of ureteroscopic surgery is rapidly evolving with the emergence of suction-based technologies. We sought to evaluate the effectiveness, safety, and surgeon experience for steerable ureteroscopic renal evacuation (SURE) using the second-generation CVAC<sup>®</sup> System. <b>Methods:</b> We reviewed all patients who underwent SURE with the CVAC 2.0 system after initial launch at a large, multicenter academic institution between February 2024 and February 2025. Postoperative adverse events within 30 days after treatment were reported. Stone burdens were measured by computed tomography (CT)-based stone volume and cumulative maximal stone diameter. Surgical effectiveness was evaluated by CT-based stone-free rates, percentage of stone clearance, and residual stone volume. <b>Results:</b> 179 patients underwent SURE by 16 surgeons of varying experience and subspecialty expertise. No intraoperative complications or device malfunctions were reported. The overall complication rate was 4.5%, including five (2.8%) infectious complications. Of the 53 renal units (47 patients) with postoperative CT imaging, the median baseline stone burden was 15 mm [Interquartile range (IQR), 10–22] and 417 mm<sup>3</sup> [IQR, 205–722]. Overall stone clearance was 99.5% and the CT-based zero stone free rate was 73.6%, improving to 90.6% for fragments ≤2 mm. <b>Conclusion:</b> Our institutional experience performing SURE with the second-generation CVAC System demonstrates its safety and effectiveness across a wide range of stone burdens and surgeon experience. This large report of real-world practice patterns and outcomes offers valuable insight for early and prospective adopters of this novel technology.
KW  - Kidney stone; flexible ureteroscopy; steerable ureteroscopic renal evacuation (SURE); CVAC System; aspiration

DO  - 10.32604/cju.2026.079115