How Medtronic designed the next generation of GI bleeding treatment

Dr. Austin Chiang at Medtronic says there are plenty of ways to treat gastrointestinal (GI) bleeding. Cauterizing wounds — treating with heat — is one, while clipping the bleed to stop it is another.

However, Medtronic (NYSE:MDT) now offers a new way that Chiang thinks just might trump them all.

The company believes its newly FDA-cleared Nexpowder endoscopic hemostasis system is the future of GI bleeding treatment.

“It’s really innovative,” Chiang, CMO of the Gastrointestinal business at Medtronic, told MassDevice in a recent interview. “It addresses a lot of the shortcomings of existing technology out there.”

What is Medtronic’s Nexpowder?

Nexpowder is a noncontact, nonthermal and nontraumatic hemostatic powder sprayed through a catheter into the GI tract. It features a proprietary powder-coating technology. Medtronic designed it to minimize catheter clogging and particle scattering without requiring carbon dioxide or air compressors.

Chiang said the spray-on powder differentiates from other offerings on the market because it reacts to moisture, not just blood. It turns into a gel that’s adhesive, sticking to the bleeding area and allowing it to heal. This reaction to moisture also means it can be used in other applications.

“With existing systems out there, sometimes these powders get in the way to clog up the machine and clog up the device or inhibit your visualization,” Chiang said. “Our device actually is a very targeted type of powder. It’s easy to control and use and it doesn’t clog up the system.”

According to Medtronic, Nexpowder features a 94% immediate hemostasis rate. It comes in at two times the adhesive force of other hemostatic sprays, the company said, and it contributes to a mere 3.7% rebleeding rate.

How Nexpowder works

The device features a handle attached to a catheter that is fed down a scope channel. That channel leads down to, for instance, an ulcer or bleeding lesion in the stomach. Chiang then said the person performing the endoscopy directly turns on the spray handle for the device and applies the powder. It delivers the powder in what he described as a motorized fashion, through the catheter onto the target lesion.

Chiang said the targeted delivery factor distinguishes Nexpowder from the rest of the market. He said that, historically, a problem has been a “scattered cloud” of powder, rather than direct delivery to the target. The reaction to moisture represents another advantage, he said.

The system features a blue gel to provide confidence that a lesion is fully covered. Additionally, the gel remains blue to simplify follow-up endoscopy.

Altogether, Chiang said the visualization aspect of Medtronic’s technology is another step forward.

“The visualization, because it’s targeted, allows us to actually see what we’re doing,” Chiang explained. “You can imagine, if it’s just a big cloud of powder, you can’t really see through that. It’s actually something that we’ve run into in the past with other systems.”

Adding to the GI portfolio

Nexpowder effectively rounds out the Medtronic gastrointestinal portfolio, which features the GI Genius for detecting colorectal polyps through enhanced visualization during colonoscopy.

The portfolio stretches across the stages of GI treatment, Chiang said, with Nexpowder fitting in as something of a final puzzle piece.

“I think [Nexpowder is] important,” Chiang said. “Our vision is really to cover the entire care continuum, and that means detection, resection and also protection. So, if we think about our portfolio, we have GI Genius, which is the kind of first-to-market AI polyp detection device that kind of serves as the detection piece of it. Then, resection is for bigger polyps that may need to be removed. We have tools that are also going to be commercialized very soon that are cleared by the FDA. And then, of course, this is the protection piece of it.

“We want to make sure that we see all of our patients through this entire spectrum.”