The relative contribution of stress waves and cavitation to the overall success of stone comminution in shock wave lithotripsy

Abstract

The disintegration of kidney stones in shock wave lithotripsy (SWL) is caused primarily by the stress waves propagating inside the stone and by the collapse of cavitation bubbles in the surrounding fluid near the stone surface. Understanding the relative contribution of these different mechanical forces to the overall success of stone comminution is critical for improving the treatment efficiency of SWL. In this talk, we will provide an overview of the experimental studies under way at Duke University to delineate the contribution of stress waves and cavitation to the overall success of stone comminution in SWL. Limitations of individual contributing factors and their synergistic interaction will also be discussed. Finally, strategies to improve stone comminution efficiency while reducing tissue injury in SWL will be presented. [Work supported by NIH DK52985 and DK58266.]