The Isolated Perfused Kidney: An<i>in Vitro</i>Test System for Evaluation of Renal Tissue Damage Induced by High-Energy Shockwaves Sources

Bergsdorf, T.; Thüroff, S.; Chaussy, C.

doi:10.1089/end.2005.19.883

Cited by 21 publications

(8 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In accordance with that idea, the experiments of Bergsdorf demonstrated that energy flux density represents the main parameter of shock wave–induced tissue trauma [63]. Lesion scores only correlated with energy density, not with negative shock wave pressure.…”

Section: Evidence Synthesismentioning

confidence: 67%

“…According to animal experiments as well as kidney perfusion models [61–63], different dose-dependent morphologic findings can be distinguished: Damage of renal parenchyma primarily occurs at vessels and tubular cells. First, venules in the medulla are damaged (grade 1 lesion), followed by rupture of cortical arterioles (grade 2/3 lesion).…”

Section: Evidence Synthesismentioning

confidence: 99%

See 1 more Smart Citation

Shock Wave Technology and Application: An Update

et al. 2011

View full text Add to dashboard Cite

Context The introduction of new lithotripters has increased problems associated with shock wave application. Recent studies concerning mechanisms of stone disintegration, shock wave focusing, coupling, and application have appeared that may address some of these problems. Objective To present a consensus with respect to the physics and techniques used by urologists, physicists, and representatives of European lithotripter companies. Evidence acquisition We reviewed recent literature (PubMed, Embase, Medline) that focused on the physics of shock waves, theories of stone disintegration, and studies on optimising shock wave application. In addition, we used relevant information from a consensus meeting of the German Society of Shock Wave Lithotripsy. Evidence synthesis Besides established mechanisms describing initial fragmentation (tear and shear forces, spallation, cavitation, quasi-static squeezing), the model of dynamic squeezing offers new insight in stone comminution. Manufacturers have modified sources to either enlarge the focal zone or offer different focal sizes. The efficacy of extracorporeal shock wave lithotripsy (ESWL) can be increased by lowering the pulse rate to 60–80 shock waves/min and by ramping the shock wave energy. With the water cushion, the quality of coupling has become a critical factor that depends on the amount, viscosity, and temperature of the gel. Fluoroscopy time can be reduced by automated localisation or the use of optical and acoustic tracking systems. There is a trend towards larger focal zones and lower shock wave pressures. Conclusions New theories for stone disintegration favour the use of shock wave sources with larger focal zones. Use of slower pulse rates, ramping strategies, and adequate coupling of the shock wave head can significantly increase the efficacy and safety of ESWL.

show abstract

Section: Evidence Synthesismentioning

confidence: 67%

Section: Evidence Synthesismentioning

confidence: 99%

Shock Wave Technology and Application: An Update

et al. 2011

View full text Add to dashboard Cite

show abstract

“…So the overall treatment complication rate of current study is the minimum, with the majority being minor complications, and no major complications were reported in the present study; however, in other studies [11], acute renal failure has been reported after ESWL [24], massive retroperitoneal hemorrhage after ESWL leading to patient death has also been reported [25]. Besides renal injury [26], ESWL is not completely free from other serious complications, such as gastrointestinal injury in1.8% of cases, including colonic perforation or duodenal erosions [27]. However, there was no association between ESWL and the subsequent long-term risk of hypertension [11] [28].…”

Section: Discussionmentioning

confidence: 48%

Extracorporeal Shock Wave Lithotripsy in the Treatment of Single Ureteric Stone. Initial Data from Iraq

Hussein¹,

Abdulhussein²,

Nawar³

et al. 2015

OJU

View full text Add to dashboard Cite

Background: Extracorporeal shock wave lithotripsy (ESWL) became the first line in the treatment of ureteric stone after failure of conservative treatment because of its safety, simplicity and effectiveness. It is not invasive procedure and can be done on outpatient basis without anesthesia and with few complications which is most probably temporary and treatable. The objective of this study is to evaluate the efficiency and safety of ESWL in treatment of ureteric stone in Iraq. Materials and Methods: A total of 112 Iraqi patients with ureteric stones were participated in this prospective observational study in which patients scheduled for ESWL treatment for a period of 6 months. Patients were divided into 2 groups: 1) Group 1: 52 patients with proximal ureteric stone; 2) Group 2: including 60 patients with distal ureteric stone. Pre-operatively all patient underwent bowel preparation and were asked to fast for 8 hours before the procedure. Results: The age ranged between 22 and 55 with mean of 42 (SD = 5) years. Around 46% had proximal ureteric stone and the rest were in distal ureter. Around 44% needed one session and 40% needed two sessions to be stone-free respectively. In regards to associated symptoms, 74% had ureteric colic, 3% haematuria, 43% microhematuria and 12% UTI. Mild hydronephrosis was found in 90% of the cases and 30 reported had previous intervention. Success rate was 90%. Conclusions: ESWL is safe and effective in treatment of ureteric stone with few complications and must be regarded first choice after conservative treatment in a patient with uncomplicated ureteric stone.

show abstract

“…Currently, the evidence indicates that a wide focal zone provides more efficient fragmentation [48,49], while high peak pressures (i.e. high energy flux densities) result in increased tissue injury [50]. Improvements to the design of the acoustic lens of a contemporary Electromagnetic Lithotripter (EML) resulted in the enlargement of the focal zone and significantly less trauma and superior fragmentation (89% stone comminution versus 54%) in a in vivo porcine model [51].…”

Section: Recent Technical Innovationsmentioning

confidence: 99%

Recent advances in lithotripsy technology and treatment strategies: A systematic review update

Elmansy

Lingeman

2016

International Journal of Surgery

View full text Add to dashboard Cite

Introduction Shock wave lithotripsy (SWL) is a well – established treatment option for urolithiasis. The technology of SWL has undergone significant changes in an attempt to better optimize the results while reducing failure rates. There are some important limitations that restrict the use of SWL. In this review, we aim to place these advantages and limitations in perspective, assess the current role of SWL, and discuss recent advances in lithotripsy technology and treatment strategies. Methods A comprehensive review was conducted to identify studies reporting outcomes on ESWL. We searched for literature (PubMed, Embase, Medline) that focused on the physics of shock waves, theories of stone disintegration, and studies on optimising shock wave application. Relevant articles in English published since 1980 were selected for inclusion. Results Efficacy has been shown to vary between lithotripters. To maximize stone fragmentation and reduce failure rates, many factors can be optimized. Factors to consider in proper patient selection include skin – to – stone distance and stone size. Careful attention to the rate of shock wave administration, proper coupling of the treatment head to the patient have important influences on the success of lithotripsy. Conclusion Proper selection of patients who are expected to respond well to SWL, as well as attention to the technical aspects of the procedure are the keys to SWL success. Studies aiming to determine the mechanisms of shock wave action in stone breakage have begun to suggest new treatment strategies to improve success rates and safety.

show abstract

The Isolated Perfused Kidney: Anin VitroTest System for Evaluation of Renal Tissue Damage Induced by High-Energy Shockwaves Sources

Cited by 21 publications

References 13 publications

Shock Wave Technology and Application: An Update

Shock Wave Technology and Application: An Update

Extracorporeal Shock Wave Lithotripsy in the Treatment of Single Ureteric Stone. Initial Data from Iraq

Recent advances in lithotripsy technology and treatment strategies: A systematic review update

Contact Info

Product

Resources

About