A mechanism of gallstone destruction by extracorporeal shock waves

Delius, Michael; Heine, G.; Brendel, W.

doi:10.1016/0016-5085(88)90725-1

Cited by 23 publications

(15 citation statements)

References 0 publications

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“…Cavitation is principally a surface-acting mechanism, and experiments indicate that in SWL a cloud of cavitation bubbles is formed which acts most strongly on the proximal (shock wave incident) surface of the stone [70,93,94]. Figure 6 shows high-speed movie images of the bubble cloud induced on the proximal surface of a kidney stone in response to a lithotripsy shock wave.…”

Section: Cavitationmentioning

confidence: 99%

Lithotripsy

Leighton

Cleveland

2009

Proc Inst Mech Eng H

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Shock wave lithotripsy (SWL) is the process of fragmentation of renal or ureteric stones by the use of repetitive shock waves generated outside the body and focused onto the stone. Following its introduction in 1980, SWL revolutionized the treatment of kidney stones by offering patients a non-invasive procedure. It is now seen as a mature technology and its use is perceived to be routine. It is noteworthy that, at the time of its introduction, there was a great effort to discover the mechanism(s) by which it works, and the type of sound field that is optimal. Although nearly three decades of subsequent research have increased the knowledge base significantly, the mechanisms are still controversial. Furthermore there is a growing body of evidence that SWL results in injury to the kidney which may have long-term side effects, such as new onset hypertension, although again there is much controversy within the field. Currently, use of lithotripsy is waning, particularly with the advent of minimally invasive ureteroscopic approaches. The goal here is to review the state of the art in SWL and to present the barriers and challenges that need to be addressed for SWL to deliver on its initial promise of a safe, effective, non-invasive treatment for kidney stones.

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Section: Cavitationmentioning

confidence: 99%

Lithotripsy

Leighton

Cleveland

2009

Proc Inst Mech Eng H

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“…Acoustic cavitation in water near the focus of a lithotripter has been reported [106,107], presumably brought about through the negative tail of the pulse. It is generally assumed in ESWL that cavitation plays some part in stone fragmentation [108] and bioeffects [106,[109][110][111][112][113][114][115][116][117]. 15 Williams et al [118] attempted to use the resonant bubble detector described in section 5.1.1(c) to detect shock-induced cavitation bubbles downstream from the exposure site of a Dornier System lithotripter.…”

Section: (D) the Detection Of Pre-existing Bubbles Through Combinatiomentioning

confidence: 99%

Effects and Mechanisms

Leighton

1994

The Acoustic Bubble

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“…Stone fracture is thought to be caused by partial reflection of the shock wave at the anterior and posterior gallstone surface, but it has also been suggested that a cavitation mechanism may be involved. 69 According to in viva studies, the ideal stone for lithotripsy is a solitary cholesterol-rich stone with a diameter ranging from 15 to 30 mm.65 According to in vifro studies,70 stone fragmentation is not influenced by the chemical composition of the stone.…”

Section: Response To Treatmentmentioning

confidence: 99%