First Series Using Ultrasonic Propulsion and Burst Wave Lithotripsy to Treat Ureteral Stones
2022; Lippincott Williams & Wilkins; Volume: 208; Issue: 5 Linguagem: Inglês
10.1097/ju.0000000000002864
ISSN1527-3792
AutoresM. Kennedy Hall, Jeff Thiel, Barbrina Dunmire, Patrick Samson, Ross Kessler, Peter Sunaryo, Robert Sweet, Ian Metzler, Helena Chang, Martin L. Gunn, Manjiri Dighe, Layla Anderson, Christina Popchoi, Ravi Managuli, Bryan W. Cunitz, Barbara H. Burke, Lisa Ding, Brianna Gutierrez, Ziyue Liu, Mathew D. Sorensen, Hunter Wessells, Michael R. Bailey, Jonathan D. Harper,
Tópico(s)Ureteral procedures and complications
ResumoNo AccessJournal of UrologyAdult Urology1 Nov 2022First Series Using Ultrasonic Propulsion and Burst Wave Lithotripsy to Treat Ureteral StonesThis article is commented on by the following:Editorial Comment M. Kennedy Hall, Jeff Thiel, Barbrina Dunmire, Patrick C. Samson, Ross Kessler, Peter Sunaryo, Robert M. Sweet, Ian S. Metzler, Helena C. Chang, Martin Gunn, Manjiri Dighe, Layla Anderson, Christina Popchoi, Ravi Managuli, Bryan W. Cunitz, Barbara H. Burke, Lisa Ding, Brianna Gutierrez, Ziyue Liu, Mathew D. Sorensen, Hunter Wessells, Michael R. Bailey, and Jonathan D. Harper M. Kennedy HallM. Kennedy Hall Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington , Jeff ThielJeff Thiel Department of Urology, University of Washington School of Medicine, Seattle, Washington , Barbrina DunmireBarbrina Dunmire Department of Urology, University of Washington School of Medicine, Seattle, Washington , Patrick C. SamsonPatrick C. Samson Department of Radiology, University of Washington School of Medicine, Seattle, Washington , Ross KesslerRoss Kessler Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington , Peter SunaryoPeter Sunaryo Department of Radiology, University of Washington School of Medicine, Seattle, Washington , Robert M. SweetRobert M. Sweet Department of Radiology, University of Washington School of Medicine, Seattle, Washington , Ian S. MetzlerIan S. Metzler Department of Radiology, University of Washington School of Medicine, Seattle, Washington , Helena C. ChangHelena C. Chang Department of Radiology, University of Washington School of Medicine, Seattle, Washington , Martin GunnMartin Gunn Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington , Manjiri DigheManjiri Dighe Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington , Layla AndersonLayla Anderson Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington , Christina PopchoiChristina Popchoi Department of Urology, University of Washington School of Medicine, Seattle, Washington , Ravi ManaguliRavi Managuli Department of Urology, University of Washington School of Medicine, Seattle, Washington , Bryan W. CunitzBryan W. Cunitz Department of Urology, University of Washington School of Medicine, Seattle, Washington , Barbara H. BurkeBarbara H. Burke Institute of Translational Health Sciences, University of Washington, Seattle, Washington , Lisa DingLisa Ding Department of Radiology, University of Washington School of Medicine, Seattle, Washington , Brianna GutierrezBrianna Gutierrez Department of Radiology, University of Washington School of Medicine, Seattle, Washington , Ziyue LiuZiyue Liu Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana , Mathew D. SorensenMathew D. Sorensen Department of Radiology, University of Washington School of Medicine, Seattle, Washington Division of Urology, VA Puget Sound Health Care System, Seattle, Washington , Hunter WessellsHunter Wessells Department of Radiology, University of Washington School of Medicine, Seattle, Washington , Michael R. BaileyMichael R. Bailey ‖Correspondence: Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th St.,Seattle, Washington 98105-6698 telephone: 206-685-8618; email: E-mail Address: m[email protected] https://orcid.org/0000-0003-0491-6465 Department of Urology, University of Washington School of Medicine, Seattle, Washington Department of Radiology, University of Washington School of Medicine, Seattle, Washington , and Jonathan D. HarperJonathan D. Harper Department of Radiology, University of Washington School of Medicine, Seattle, Washington View All Author Informationhttps://doi.org/10.1097/JU.0000000000002864AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Our goal was to test transcutaneous focused ultrasound in the form of ultrasonic propulsion and burst wave lithotripsy to reposition ureteral stones and facilitate passage in awake subjects. Materials and Methods: Adult subjects with a diagnosed proximal or distal ureteral stone were prospectively recruited. Ultrasonic propulsion alone or with burst wave lithotripsy was administered by a handheld transducer to awake, unanesthetized subjects. Efficacy outcomes included stone motion, stone passage, and pain relief. Safety outcome was the reporting of associated anticipated or adverse events. Results: Twenty-nine subjects received either ultrasonic propulsion alone (n = 16) or with burst wave lithotripsy bursts (n = 13), and stone motion was observed in 19 (66%). The stone passed in 18 (86%) of the 21 distal ureteral stone cases with at least 2 weeks follow‐up in an average of 3.9±4.9 days post-procedure. Fragmentation was observed in 7 of the burst wave lithotripsy cases. All subjects tolerated the procedure with average pain scores (0-10) dropping from 2.1±2.3 to 1.6±2.0 (P = .03). Anticipated events were limited to hematuria on initial urination post-procedure and mild pain. In total, 7 subjects had associated discomfort with only 2.2% (18 of 820) propulsion bursts. Conclusions: This study supports the efficacy and safety of using ultrasonic propulsion and burst wave lithotripsy in awake subjects to reposition and break ureteral stones to relieve pain and facilitate passage. References 1. . Emergency department visits, use of imaging, and drugs for urolithiasis have increased in the United States. Kidney Int. 2013; 83(3):479-486. Google Scholar 2. . Kidney Stones.Washington, DC: Urologic Diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases US Government Printing Office NIH Publication No. 20172018:12-7865. Google Scholar 3. . 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Abstract, Google Scholar 10. . The accuracy and prognostic value of point-of-care ultrasound for nephrolithiasis in the emergency department: a systematic review and meta-analysis. Acad Emerg Med. 2018; 25(6):684-698. Google Scholar 11. . Ureteral stone location at emergency room presentation with colic. J Urol. 2009; 182(1):165-168. Link, Google Scholar 12. . In vitro evaluation of urinary stone comminution with a clinical burst wave lithotripsy system.J Endourol. 2020; 34(11):1167-1173. Google Scholar 13. . Safety and effectiveness of a longer focal beam and burst duration in ultrasonic propulsion for repositioning urinary stones and fragments.J Endourol. 2017; 31(8):793-799. Google Scholar 14. . Detection and evaluation of renal injury in burst wave lithotripsy using ultrasound and magnetic resonance imaging. J Endourol. 2017; 31(8):786-792. Google Scholar 15. . Modeling and experimental analysis of acoustic cavitation bubbles for burst wave lithotripsy. J Phys Conf Ser. 2015; 656: 012027. Google Scholar 16. . Document number 1226: content of premarket notifications (510(k)s) for extracorporeal shock wave lithotripters indicated for the fragmentation of kidney and ureteral calculi - guidance for industry and for FDA reviewers. U.S. Department of Health and Human Services; 2000. Updated July 18, 2018. https://www.fda.gov/medical-devices/. Google Scholar 17. . How can and should we optimize extracorporeal shockwave lithotripsy?Urolithiasis. 2018; 46(1):3-17. Google Scholar 18. . PIEZO2 in sensory neurons and urothelial cells coordinates urination. Nature. 2020; 588(7837):290-295. Google Scholar 19. . Optimal pulse length of insonification for Piezo1 activation and intracellular calcium response. Scientific Rep. 2021; 11(1):709-723. Google Scholar 20. . Pearl-unjammed: the Seattle stone maneuver for ureteropelvic junction urolithiasis. J Am Coll Emerg Physicians Open. 2020; 1(3):252-256. Google Scholar 21. . Tamsulosin as a medical expulsive therapy for ureteral stones: a systematic review and meta-analysis of randomized controlled trials. J Urol. 2019; 201(5): 950-955. Link, Google Scholar Submitted March 30, 2022; accepted July 8, 2022; published October 7, 2022. Support: The study was supported by NASA HRP ExMC MTL ID 1265 through a contract with ZIN Technologies. System and research infrastructure development was supported by NIH NIDDK P01 DK043881, NIH K01 DK104854, and the National Space Biomedical Research Institute. Conflict of Interest: MB, BC, BD, and MS have consulting agreements with and equity in SonoMotion, Inc., which has licensed this technology from the University of Washington for commercialization. RMS: American Urological Association, Elsevier Publishing (Campbells Urology). ISM: Bard BD, Perceus Inc. MD: Philips Medical Imaging, General Electric Healthcare. Ethics Statement: This study received Institutional Review Board approval (IRB No. STUDY00002746). © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKaplan-Marans E (2022) First Series Using Ultrasonic Propulsion and Burst Wave Lithotripsy to Treat Ureteral Stones. Letter.Journal of Urology, VOL. 209, NO. 2, (325-326), Online publication date: 1-Feb-2023.Related articlesJournal of Urology1 Nov 2022Editorial Comment Volume 208Issue 5November 2022Page: 1075-1082Supplementary Materials PEER REVIEW REPORTS Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.KeywordslithotripsyurolithiasisultrasoundcalculiAcknowledgmentsWe thank our research coordinators and colleagues.MetricsAuthor Information M. Kennedy Hall Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington More articles by this author Jeff Thiel Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author Barbrina Dunmire Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author Patrick C. Samson Department of Radiology, University of Washington School of Medicine, Seattle, Washington Current affiliation: Department of Urology, Weill Cornell Medical College, New York, New York. More articles by this author Ross Kessler Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington More articles by this author Peter Sunaryo Department of Radiology, University of Washington School of Medicine, Seattle, Washington Current affiliation: Kaiser Permanente, Sunnybrook Medical Office, Clackamas, Oregon. More articles by this author Robert M. Sweet Department of Radiology, University of Washington School of Medicine, Seattle, Washington More articles by this author Ian S. Metzler Department of Radiology, University of Washington School of Medicine, Seattle, Washington Current affiliation: Oregon Health and Sciences University, Portland, Oregon. More articles by this author Helena C. Chang Department of Radiology, University of Washington School of Medicine, Seattle, Washington Current affiliation: Kaiser Permanente, Santa Clara Homestead Medical Center, Santa Clara, California. More articles by this author Martin Gunn Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington More articles by this author Manjiri Dighe Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington More articles by this author Layla Anderson Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington More articles by this author Christina Popchoi Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author Ravi Managuli Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author Bryan W. Cunitz Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author Barbara H. Burke Institute of Translational Health Sciences, University of Washington, Seattle, Washington More articles by this author Lisa Ding Department of Radiology, University of Washington School of Medicine, Seattle, Washington More articles by this author Brianna Gutierrez Department of Radiology, University of Washington School of Medicine, Seattle, Washington More articles by this author Ziyue Liu Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana More articles by this author Mathew D. Sorensen Department of Radiology, University of Washington School of Medicine, Seattle, Washington Division of Urology, VA Puget Sound Health Care System, Seattle, Washington More articles by this author Hunter Wessells Department of Radiology, University of Washington School of Medicine, Seattle, Washington More articles by this author Michael R. Bailey Department of Urology, University of Washington School of Medicine, Seattle, Washington Department of Radiology, University of Washington School of Medicine, Seattle, Washington ‖Correspondence: Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th St.,Seattle, Washington 98105-6698 telephone: 206-685-8618; email: E-mail Address: [email protected] More articles by this author Jonathan D. Harper Department of Radiology, University of Washington School of Medicine, Seattle, Washington More articles by this author Expand All Submitted March 30, 2022; accepted July 8, 2022; published October 7, 2022. Support: The study was supported by NASA HRP ExMC MTL ID 1265 through a contract with ZIN Technologies. System and research infrastructure development was supported by NIH NIDDK P01 DK043881, NIH K01 DK104854, and the National Space Biomedical Research Institute. Conflict of Interest: MB, BC, BD, and MS have consulting agreements with and equity in SonoMotion, Inc., which has licensed this technology from the University of Washington for commercialization. RMS: American Urological Association, Elsevier Publishing (Campbells Urology). ISM: Bard BD, Perceus Inc. MD: Philips Medical Imaging, General Electric Healthcare. Ethics Statement: This study received Institutional Review Board approval (IRB No. STUDY00002746). Advertisement PDF downloadLoading ...
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