Air Pockets Trapped During Routine Coupling in Dry Head Lithotripsy Can Significantly Decrease the Delivery of Shock Wave Energy

Pishchalnikov, Yuri A.; Neucks, Joshua S.; VonDerHaar, R. Jason; Pishchalnikova, Irina V.; Williams, James C.; McAteer, James A.

doi:10.1016/j.juro.2006.07.149

Cited by 102 publications

(52 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The treatment head of the lithotripter was coupled to the test tank through a Mylar membrane as previously described. 7 The majority of experiments were performed in non-degassed tap water. The dissolved oxygen content was measured using an YSI DO200 oxygen meter (YSI, Inc., Yellow Springs, OH) and was at about 8 ppm or near 100% of saturation.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Bubble proliferation in the cavitation field of a shock wave lithotripter

Pishchalnikov

Williams

McAteer

2011

The Journal of the Acoustical Society of America

Self Cite

View full text Add to dashboard Cite

Lithotripter shock waves (SWs) generated in non-degassed water at 0.5 and 2 Hz pulse repetition frequency (PRF) were characterized using a fiber-optic hydrophone. High-speed imaging captured the inertial growth-collapse-rebound cycle of cavitation bubbles, and continuous recording with a 60 fps camcorder was used to track bubble proliferation over successive SWs. Microbubbles that seeded the generation of bubble clouds formed by the breakup of cavitation jets and by bubble collapse following rebound. Microbubbles that persisted long enough served as cavitation nuclei for subsequent SWs, as such bubble clouds were enhanced at fast PRF. Visual tracking suggests that bubble clouds can originate from single bubbles.

show abstract

Section: Methodsmentioning

confidence: 99%

“…The 100 lm glass fiber tip of the hydrophone was positioned at the focus (F) of the lithotripter 7 and is faintly visible in camcorder images. The temporal profile of a lithotripter pulse consisted of a $2 ls leading positive-pressure phase followed by a $5 ls negative-pressure phase and trailing residual oscillations.…”

Section: Methodsmentioning

confidence: 99%

Bubble proliferation in the cavitation field of a shock wave lithotripter

Pishchalnikov

Williams

McAteer

2011

The Journal of the Acoustical Society of America

Self Cite

View full text Add to dashboard Cite

show abstract

“…This has negatively impacted the outcome as air bubbles that form within the medium dampen the energy and reduce the impact on the stone. Efficacy can be reduced by as much as 40% with the presence of as few as 2% of air pockets [38] . Avoiding patient movement or repositioning during the procedure will lessen the impact of this effect minimizing the number of air pockets created.…”

Section: Treatment Parametersmentioning

confidence: 99%

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Semins

Matlaga

2015

WJN

View full text Add to dashboard Cite

Shock wave lithotripsy (SWL) was introduced in 1980, modernizing the treatment of upper urinary tract stones, and quickly became the most commonly utilized technique to treat kidney stones. Over the past 5-10 years, however, use of SWL has been declining because it is not as reliably effective as more modern technology. SWL success rates vary considerably and there is abundant literature predicting outcome based on patient-and stone-specific parameters. Herein we discuss the ways to optimize SWL outcomes by reviewing proper patient selection utilizing stone characteristics and patient features. Stone size, number, location, density, composition, and patient body habitus and renal anatomy are all discussed. We also review the technical parameters during SWL that can be controlled to improve results further, including type of anesthesia, coupling, shock wave rate, focal zones, pressures, and active monitoring. Following these basic principles and selection criteria will help maximize success rate. Core tip: Shock wave lithotripsy is a commonly utilized technology for kidney stone treatment that has declining efficacy over the past decade. The paper outlines how to optimize outcomes with proper patient selection and control of treatment parameters.

show abstract

“…De-coupling and re-coupling, which may occur during the repositioning of a patient during SWL, can generate large volume air pockets in the coupling medium. Such air pockets can have a dramatic effect on treatment efficacy: air pockets of just 2% of the coupling interface reduce breakage by 20-40% [Neucks et al 2008;Pishchalnikov et al 2006]. Although there is no way to monitor coupling during treatment, simple steps can minimize the likelihood of air pockets developing.…”

Section: Technical Factorsmentioning

confidence: 99%

How to improve results with extracorporeal shock wave lithotripsy

Semins

Matlaga

2009

Therapeutic Advances in Urology

View full text Add to dashboard Cite

Abstract:Objective: Shock wave lithotripsy (SWL) has greatly revolutionized the treatment of patients suffering from stone disease. There are a number of patient-and device-specific factors that can affect treatment outcome. Herein, we review practices that can increase the likelihood of SWL treatment success. Methods: A systematic literature review was performed to identify studies of SWL treatment parameters. Results: Among the factors affecting the outcome of SWL were patient selection criteria, such as stone burden, stone location, and anatomic features. Additionally, technical aspects of the SWL procedure also can affect outcome; these factors include the acoustic output of the lithotripter, the coupling of the lithotripter to the patient, and the power, total number, and rate of shock wave delivery. Conclusions: The outcome of SWL can be optimized with close attention to patient selection criteria as well as the manner in which the treatment is performed.

show abstract

Air Pockets Trapped During Routine Coupling in Dry Head Lithotripsy Can Significantly Decrease the Delivery of Shock Wave Energy

Cited by 102 publications

References 15 publications

Bubble proliferation in the cavitation field of a shock wave lithotripter

Bubble proliferation in the cavitation field of a shock wave lithotripter

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

How to improve results with extracorporeal shock wave lithotripsy

Contact Info

Product

Resources

About