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Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter.

dc.contributor.author Fovargue, DE
dc.contributor.author Kuntz, NJ
dc.contributor.author Lipkin, ME
dc.contributor.author Madden, JF
dc.contributor.author Mitran, S
dc.contributor.author Neisius, A
dc.contributor.author Preminger, GM
dc.contributor.author Sankin, Georgy
dc.contributor.author Simmons, WN
dc.contributor.author Smith, NB
dc.contributor.author Zhong, P
dc.coverage.spatial United States
dc.date.accessioned 2014-03-20T18:09:44Z
dc.date.issued 2014-04-01
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/24639497
dc.identifier 1319203111
dc.identifier.uri https://hdl.handle.net/10161/8403
dc.description.abstract The efficiency of shock wave lithotripsy (SWL), a noninvasive first-line therapy for millions of nephrolithiasis patients, has not improved substantially in the past two decades, especially in regard to stone clearance. Here, we report a new acoustic lens design for a contemporary electromagnetic (EM) shock wave lithotripter, based on recently acquired knowledge of the key lithotripter field characteristics that correlate with efficient and safe SWL. The new lens design addresses concomitantly three fundamental drawbacks in EM lithotripters, namely, narrow focal width, nonidealized pulse profile, and significant misalignment in acoustic focus and cavitation activities with the target stone at high output settings. Key design features and performance of the new lens were evaluated using model calculations and experimental measurements against the original lens under comparable acoustic pulse energy (E+) of 40 mJ. The -6-dB focal width of the new lens was enhanced from 7.4 to 11 mm at this energy level, and peak pressure (41 MPa) and maximum cavitation activity were both realigned to be within 5 mm of the lithotripter focus. Stone comminution produced by the new lens was either statistically improved or similar to that of the original lens under various in vitro test conditions and was significantly improved in vivo in a swine model (89% vs. 54%, P = 0.01), and tissue injury was minimal using a clinical treatment protocol. The general principle and associated techniques described in this work can be applied to design improvement of all EM lithotripters.
dc.language eng
dc.relation.ispartof Proc Natl Acad Sci U S A
dc.relation.isversionof 10.1073/pnas.1319203111
dc.subject electromagnetic lithotripter
dc.subject lens modification
dc.subject stone fragmentation
dc.subject Animals
dc.subject Electromagnetic Phenomena
dc.subject Equipment Design
dc.subject Female
dc.subject Lenses
dc.subject Lithotripsy
dc.subject Motion
dc.subject Respiration
dc.subject Skin
dc.subject Sus scrofa
dc.title Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/24639497
pubs.begin-page E1167
pubs.end-page E1175
pubs.issue 13
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 Pathology
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 111
dc.identifier.eissn 1091-6490


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