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Fragmentation of Urinary Calculi In Vitro by Burst Wave Lithotripsy

2014; Lippincott Williams & Wilkins; Volume: 193; Issue: 1 Linguagem: Inglês

10.1016/j.juro.2014.08.009

1527-3792

Adam D. Maxwell, Bryan W. Cunitz, Wayne Kreider, Oleg A. Sapozhnikov, Ryan S. Hsi, Jonathan D. Harper, Michael R. Bailey, Mathew D. Sorensen,

Radioactive element chemistry and processing

No AccessJournal of UrologyInvestigative Urology1 Jan 2015Fragmentation of Urinary Calculi In Vitro by Burst Wave Lithotripsy Adam D. Maxwell, Bryan W. Cunitz, Wayne Kreider, Oleg A. Sapozhnikov, Ryan S. Hsi, Jonathan D. Harper, Michael R. Bailey, and Mathew D. Sorensen Adam D. MaxwellAdam D. Maxwell Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington , Bryan W. CunitzBryan W. Cunitz Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington , Wayne KreiderWayne Kreider Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington , Oleg A. SapozhnikovOleg A. Sapozhnikov Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington Department of Acoustics, Physics Faculty, Moscow State University, Moscow, Russia , Ryan S. HsiRyan S. Hsi Department of Urology, School of Medicine, University of Washington, Seattle, Washington , Jonathan D. HarperJonathan D. Harper Department of Urology, School of Medicine, University of Washington, Seattle, Washington , Michael R. BaileyMichael R. Bailey Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington , and Mathew D. SorensenMathew D. Sorensen Department of Urology, School of Medicine, University of Washington, Seattle, Washington Division of Urology, Department of Veteran Affairs Medical Center, Seattle, Washington View All Author Informationhttps://doi.org/10.1016/j.juro.2014.08.009AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We developed a new method of lithotripsy that uses short, broadly focused bursts of ultrasound rather than shock waves to fragment stones. We investigated the characteristics of stone comminution by burst wave lithotripsy in vitro. Materials and Methods: Artificial and natural stones (mean ± SD size 8.2 ± 3.0 mm, range 5 to 15) were treated with ultrasound bursts using a focused transducer in a water bath. Stones were exposed to bursts with focal pressure amplitude of 6.5 MPa or less at a 200 Hz burst repetition rate until completely fragmented. Ultrasound frequencies of 170, 285 and 800 kHz were applied using 3 transducers, respectively. Time to fragmentation for each stone type was recorded and fragment size distribution was measured by sieving. Results: Stones exposed to ultrasound bursts were fragmented at focal pressure amplitudes of 2.8 MPa or greater at 170 kHz. Fractures appeared along the stone surface, resulting in fragments that separated at the surface nearest to the transducer until the stone was disintegrated. All natural and artificial stones were fragmented at the highest focal pressure of 6.5 MPa with a mean treatment duration of 36 seconds for uric acid stones to 14.7 minutes for cystine stones. At a frequency of 170 kHz the largest artificial stone fragments were less than 4 mm. Exposure at 285 and 800 kHz produced only fragments less than 2 mm and less than 1 mm, respectively. Conclusions: Stone comminution with burst wave lithotripsy is feasible as a potential noninvasive treatment method for nephrolithiasis. Adjusting the fundamental ultrasound frequency allows for stone fragment size to be controlled. References 1 : Current practice patterns in the management of upper urinary tract calculi in the north central United States. J Endourol2008; 22: 631. Google Scholar 2 : Practice patterns in the treatment of large renal stones. J Endourol2003; 17: 355. Google Scholar 3 : Contemporary surgical management of upper urinary tract calculi. J Urol2009; 181: 2152. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHarper J, Lingeman J, Sweet R, Metzler I, Sunaryo P, Williams J, Maxwell A, Thiel J, Cunitz B, Dunmire B, Bailey M and Sorensen M (2022) Fragmentation of Stones by Burst Wave Lithotripsy in the First 19 HumansJournal of Urology, VOL. 207, NO. 5, (1067-1076), Online publication date: 1-May-2022.Sorensen M, Thiel J, Dai J, Bailey M, Dunmire B, Samson P, Chang H, Hall M, Gutierrez B, Sweet R and Harper J (2019) In-Office Ultrasound Facilitates Timely Clinical Care at a Multidisciplinary Kidney Stone CenterUrology Practice, VOL. 7, NO. 3, (167-173), Online publication date: 1-May-2020.Assimos D (2019) Re: The Impact of Dust and Confinement on Fragmentation of Kidney Stones by Shockwave Lithotripsy in Tissue PhantomsJournal of Urology, VOL. 201, NO. 5, (854-854), Online publication date: 1-May-2019.Andersson K (2018) This Month in Investigative UrologyJournal of Urology, VOL. 193, NO. 1, (6-7), Online publication date: 1-Jan-2015. Volume 193Issue 1January 2015Page: 338-344 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordssoundultrasonic therapykidneylithotripsynephrolithiasisAcknowledgmentsProf. James Williams, Indiana University-Purdue University Indianapolis, provided natural stones. Spectroscopic analysis of natural stones was done at Beck Analytical Laboratories, Greenwood, Indiana.MetricsAuthor Information Adam D. Maxwell Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington More articles by this author Bryan W. Cunitz Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington More articles by this author Wayne Kreider Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington More articles by this author Oleg A. Sapozhnikov Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington Department of Acoustics, Physics Faculty, Moscow State University, Moscow, Russia More articles by this author Ryan S. Hsi Department of Urology, School of Medicine, University of Washington, Seattle, Washington More articles by this author Jonathan D. Harper Department of Urology, School of Medicine, University of Washington, Seattle, Washington More articles by this author Michael R. Bailey Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington More articles by this author Mathew D. Sorensen Department of Urology, School of Medicine, University of Washington, Seattle, Washington Division of Urology, Department of Veteran Affairs Medical Center, Seattle, Washington More articles by this author Expand All Advertisement PDF downloadLoading ...