Life-threatening Hypoxemia after Lithotripsy in an Adult Due to Shock-wave–Induced Pulmonary Contusion

Malhotra, Vinod; Rosen, Robert J.; Slepian, Ralph

doi:10.1097/00000542-199109000-00023

Cited by 22 publications

(10 citation statements)

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“…Percutaneous application reportedly achieves similar results but requires repeated myocardial application, adding complexity to what could be a straightforward therapeutic adjunct to surgical revascularization (Nishida et al ., ; Uwatoku et al ., ; Khattab et al ., ). Furthermore, narrow acoustic windows limit the distribution of percutaneously delivered cardiac shock‐wave therapy, which has the risk of side‐effects such as pulmonary damage (Malhotra et al ., ).…”

Section: Discussionmentioning

confidence: 97%

Epicardial shock-wave therapy improves ventricular function in a porcine model of ischaemic heart disease

Holfeld

Zimpfer

Albrecht-Schgoer

et al. 2014

J Tissue Eng Regen Med

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Previously we have shown that epicardial shock-wave therapy improves left ventricular ejection fraction (LVEF) in a rat model of myocardial infarction. In the present experiments we aimed to address the safety and efficacy of epicardial shock-wave therapy in a preclinical large animal model and to further evaluate mechanisms of action of this novel therapy. Four weeks after left anterior descending (LAD) artery ligation in pigs, the animals underwent re-thoracotomy with (shock-wave group, n = 6) or without (control group, n = 5) epicardial shock waves (300 impulses at 0.38 mJ/mm ) applied to the infarcted anterior wall. Efficacy endpoints were improvement of LVEF and induction of angiogenesis 6 weeks after shock-wave therapy. Safety endpoints were haemodynamic stability during treatment and myocardial damage. Four weeks after LAD ligation, LVEF decreased in both the shock-wave (43 ± 3%, p < 0.001) and control (41 ± 4%, p = 0.012) groups. LVEF markedly improved in shock-wave animals 6 weeks after treatment (62 ± 9%, p = 0.006); no improvement was observed in controls (41 ± 4%, p = 0.36), yielding a significant difference. Quantitative histology revealed significant angiogenesis 6 weeks after treatment (controls 2 ± 0.4 arterioles/high-power field vs treatment group 9 ± 3; p = 0.004). No acute or chronic adverse effects were observed. As a potential mechanism of action in vitro experiments showed stimulation of VEGF receptors after shock-wave treatment in human coronary artery endothelial cells. Epicardial shock-wave treatment in a large animal model of ischaemic heart failure exerted a positive effect on LVEF improvement and did not show any adverse effects. Angiogenesis was induced by stimulation of VEGF receptors. Copyright © 2014 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 97%

Epicardial shock-wave therapy improves ventricular function in a porcine model of ischaemic heart disease

Holfeld

Zimpfer

Albrecht-Schgoer

et al. 2014

J Tissue Eng Regen Med

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“…Maker and Layke [17] reported 10 bowel perforations in 3,423 patients (0.34%) after SWL. Pulmonary injuries are seen mostly in children and can be prevented by prophylactic padding of torso [18,19]. Subcapsular liver hematomas, fistulas as ureteroenteric, pyelocutaneous fistula especially in xanthogranulomatous kidney have been reported in literature [20,21].…”

Section: Discussionmentioning

confidence: 99%

Standardized Grading of Shock Wave Lithotripsy Complications with Modified Clavien System

Mittal¹,

Srivastava

Kappor

et al. 2016

Urol Int

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Introduction: Definitive consensus on grading of complications of shock wave lithotripsy (SWL) does not exist. The objective of this study was to grade complications of SWL in relation to different stone and shock wave parameters, according to the modified Clavien system. Materials and Methods: Complications observed in 2,648 patients who underwent SWL between January 2003 and May 2014 were evaluated statistically and stratified into 5 grades by the modified Clavien system focusing on stone and shock wave parameters. Results: Statistically significant association (p ≤ 0.05) was found between SWL outcome, Clavien grade of complications and stone and shock wave parameters. According to the modified Clavien system, grades I, II, IIIa, IIIb, IV and V complications were observed in 1,811 (68.39%), 619 (23.37%), 183 (6.91%), 34 (1.28%), nil (0.00%) and 1 (0.03%) patients, respectively. The overall success rate at 3 months was 87.72%. Conclusions: The modified Clavien system provides a standardized grading of SWL complications and can be used to standardize procedural errors and maintain quality, thereby preventing associated complications and improving the overall management and hence outcome of SWL.

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“…Life threatening hypoxemia following ESWL has also been reported [11]. Our patient, however, had moderate hypoxemia.…”

Section: Discussionmentioning

confidence: 48%

Lung contusion and cavitation with exudative plural effusion following extracorporeal shock wave lithotripsy in an adult: a case report

et al. 2010

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IntroductionAmong the complications of extracorporeal shock wave lithotripsy are perinephric bleeding and hypertension.Case presentationWe describe the case of a 31-year-old Asian man with an unusual case of hemoptysis and lung contusion and cavitation with exudative plural effusion due to pulmonary trauma following false positioning of extracorporeal shock wave lithotripsy. Differential diagnoses included pneumonia and pulmonary emboli, but these diagnoses were ruled out by the uniformly negative results of a lung perfusion scan, Doppler ultrasound, and culture of bronchoalveolar lavage and plural effusion, and because our patient showed spontaneous improvement.ConclusionsFalse positioning of extracorporeal shock wave lithotripsy can cause lung trauma presenting as pulmonary contusion and cavitation with plural effusion.

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Life-threatening Hypoxemia after Lithotripsy in an Adult Due to Shock-wave–Induced Pulmonary Contusion

Cited by 22 publications

References 0 publications

Epicardial shock-wave therapy improves ventricular function in a porcine model of ischaemic heart disease

Epicardial shock-wave therapy improves ventricular function in a porcine model of ischaemic heart disease

Standardized Grading of Shock Wave Lithotripsy Complications with Modified Clavien System

Lung contusion and cavitation with exudative plural effusion following extracorporeal shock wave lithotripsy in an adult: a case report

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