| Autor: |
Maloney, Michaella E., Marguet, Charles G., Zhou, Yufeng, Kang, David E., Sung, Jeffery C., Springhart, W. Patrick, Madden, John, Zhong, Pei, Preminger, Glenn M. |
| Zdroj: |
Journal of Endourology; September 2006, Vol. 20 Issue: 9 p603-606, 4p |
| Abstrakt: |
Background and Purpose:Shockwave lithotripsy (SWL) has become a first-line intervention for treatment of nephrolithiasis. However, few studies have examined the effects of modifications in the method of shockwave energy administration on comminution efficiency. We propose that a gradual increase in output voltage will produce superior stone fragmentation in comparison with a constant or a decreasing output voltage by optimizing the stress wave and cavitation erosion forces on renal calculi.Materials and Methods:BegoStone®phantoms were implanted in the renal pelvis of 11 pigs that underwent SWL at a pulse repetition rate of 1 Hz. Animals in the increasing strategy group (N = 4) were subjected to 18, 20, and 22 kV for 600, 600, and 800 shocks, respectively. The second group (N = 4) received a decreasing strategy of 22, 20, and 18 kV for 800, 600, and 600 shocks, respectively. The third group (N = 3) received all 2000 shocks at 20 kV, mimicking the clinical protocol.Results:A progressively decreasing strategy and constant output voltage produced a mean comminution efficiency, or percentage of stone fragments <2 mm, of 89.0% ± 3.3% and 87.6% ± 1.7%, respectively. The mean comminution efficiency was improved to 96.5% ± 1.4% by using the increasing strategy (P= 0.01).Conclusions:A progressive increase in lithotripter output voltage during SWL can produce greater stone fragmentation than protocols employing constant or decreasing output voltage. |
| Databáze: |
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