Abstract
Fast shock wave (SW) rates in lithotripsy (SWL) generate enhanced cavitation that could promote stone fragmentation. We tested the idea that SWL at the high end of clinical SW rate (2 Hz) acts to improve stone comminution. Model stones (Ultracal-30 cement) were exposed to SWs (20 kV, 400 SWs) at 0.2, 0.5, 1, and 2 Hz in a research electrohydraulic lithotripter. Fragmentation was assessed by measuring number, size, and projected surface area of the fragments. Stones treated at 0.2 Hz exhibited significantly greater fragmentation (p<0.01) than stones at 1 or 2 Hz, while fragmentation between 0.2 and 0.5 Hz was similar. Mean ± SEM for fragment area increase was 370±53% at 0.2 Hz (n=10 stones), 280±34 at 0.5 Hz (8), 130±31 at 1 Hz (5), and 101±16 at 2 Hz (20). This pronounced enhancement of fragmentation at very slow SW rate was unexpected. High-speed camera images of cavitation at solid objects show an increased bubble cloud at faster SW rates. The bubble cloud may interfere with transmission of acoustic energy to the stone surface. These in vitro data suggest the possibility that patient treatment at fast SW delivery rates may decrease the efficiency of stone comminution. [Work supported by NIH P01-DK43881.]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
