dc.contributor.author |
Yong, Daniel Z |
|
dc.contributor.author |
Lipkin, Michael E |
|
dc.contributor.author |
Simmons, W Neal |
|
dc.contributor.author |
Sankin, Georgy |
|
dc.contributor.author |
Albala, David M |
|
dc.contributor.author |
Zhong, Pei |
|
dc.contributor.author |
Preminger, Glenn M |
|
dc.coverage.spatial |
United States |
|
dc.date.accessioned |
2012-01-20T17:34:37Z |
|
dc.date.issued |
2011-09 |
|
dc.identifier |
http://www.ncbi.nlm.nih.gov/pubmed/21834658 |
|
dc.identifier.uri |
https://hdl.handle.net/10161/5090 |
|
dc.description.abstract |
BACKGROUND AND PURPOSE: Previous studies have demonstrated that treatment strategy
plays a critical role in ensuring maximum stone fragmentation during shockwave lithotripsy
(SWL). We aimed to develop an optimal treatment strategy in SWL to produce maximum
stone fragmentation. MATERIALS AND METHODS: Four treatment strategies were evaluated
using an in-vitro experimental setup that mimics stone fragmentation in the renal
pelvis. Spherical stone phantoms were exposed to 2100 shocks using the Siemens Modularis
(electromagnetic) lithotripter. The treatment strategies included increasing output
voltage with 100 shocks at 12.3 kV, 400 shocks at 14.8 kV, and 1600 shocks at 15.8
kV, and decreasing output voltage with 1600 shocks at 15.8 kV, 400 shocks at 14.8
kV, and 100 shocks at 12.3 kV. Both increasing and decreasing voltages models were
run at a pulse repetition frequency (PRF) of 1 and 2 Hz. Fragmentation efficiency
was determined using a sequential sieving method to isolate fragments less than 2
mm. A fiberoptic probe hydrophone was used to characterize the pressure waveforms
at different output voltage and frequency settings. In addition, a high-speed camera
was used to assess cavitation activity in the lithotripter field that was produced
by different treatment strategies. RESULTS: The increasing output voltage strategy
at 1 Hz PRF produced the best stone fragmentation efficiency. This result was significantly
better than the decreasing voltage strategy at 1 Hz PFR (85.8% vs 80.8%, P=0.017)
and over the same strategy at 2 Hz PRF (85.8% vs 79.59%, P=0.0078). CONCLUSIONS: A
pretreatment dose of 100 low-voltage output shockwaves (SWs) at 60 SWs/min before
increasing to a higher voltage output produces the best overall stone fragmentation
in vitro. These findings could lead to increased fragmentation efficiency in vivo
and higher success rates clinically.
|
|
dc.language |
eng |
|
dc.language.iso |
en_US |
|
dc.publisher |
Mary Ann Liebert Inc |
|
dc.relation.ispartof |
J Endourol |
|
dc.relation.isversionof |
10.1089/end.2010.0732 |
|
dc.subject |
Humans |
|
dc.subject |
Kidney Calculi |
|
dc.subject |
Lithotripsy |
|
dc.subject |
Phantoms, Imaging |
|
dc.subject |
Treatment Outcome |
|
dc.title |
Optimization of treatment strategy used during shockwave lithotripsy to maximize stone
fragmentation efficiency.
|
|
dc.type |
Journal article |
|
duke.contributor.id |
Lipkin, Michael E|0515363 |
|
duke.contributor.id |
Simmons, W Neal|0213948 |
|
duke.contributor.id |
Zhong, Pei|0115724 |
|
duke.contributor.id |
Preminger, Glenn M|0098801 |
|
duke.description.issue |
9 |
|
duke.description.volume |
25 |
|
pubs.author-url |
http://www.ncbi.nlm.nih.gov/pubmed/21834658 |
|
pubs.begin-page |
1507 |
|
pubs.end-page |
1511 |
|
pubs.issue |
9 |
|
pubs.organisational-group |
Biomedical Engineering |
|
pubs.organisational-group |
Clinical Science Departments |
|
pubs.organisational-group |
Duke |
|
pubs.organisational-group |
Mechanical Engineering and Materials Science |
|
pubs.organisational-group |
Pratt School of Engineering |
|
pubs.organisational-group |
School of Medicine |
|
pubs.organisational-group |
Surgery |
|
pubs.organisational-group |
Surgery, Urology |
|
pubs.publication-status |
Published |
|
pubs.volume |
25 |
|
dc.identifier.eissn |
1557-900X |
|
duke.contributor.orcid |
Preminger, Glenn M|0000-0003-4287-602X |
|