Absorbable Conductive Electrotherapeutic Scaffolds (ACES) for Enhanced Peripheral Nerve Regeneration and Stimulation

While peripheral nerve stimulation (PNS) has shown promise in applications ranging from peripheral nerve regeneration after injury to therapeutic organ stimulation, clinical implementation has been impeded by various technological limitations, including surgical placement, lead migration, and atraumatic removal. Here, we describe the design and validation of a new platform for nerve regeneration and interfacing: Absorbable, Conductive, Electrotherapeutic Scaffolds (ACES). ACES are comprised of an alginate/poly-acrylamide interpenetrating network hydrogel optimized for both open and minimally invasive percutaneous approaches. In a rodent model of sciatic nerve repair, ACES significantly improved motor and sensory recovery ( p < 0.05), increased muscle mass ( p < 0.05), and increased axonogenesis ( p < 0.05). Triggered dissolution of ACES enabled atraumatic, percutaneous removal of leads at forces significantly lower than controls ( p < 0.05). In a porcine model, ultrasound-guided percutaneous placement of leads with an injectable ACES near the femoral and cervical vagus nerves facilitated stimulus conduction at significantly greater lengths than saline controls ( p < 0.05). Overall, ACES facilitated lead placement, stabilization, stimulation and atraumatic removal enabling therapeutic PNS as demonstrated in small and large animal models. ### Competing Interest Statement S.S., L.G., P.K, A.S., R.L., G.T. report a provisional patent application (63/240,061) describing the ACES system. Complete details of all relationships for profit and not for profit for G.T. can be found at the following link: . Complete details for R.L. can be found at the following link: . A.S is chief medical officer and on the board of CareSignal Health, a digital health company, unrelated to the current work. He is supported by the RSNA Resident Research Award. All other authors declared that they have no competing interests related to the work reported here.