Stone comminution correlates with the average peak pressure incident on a stone during shock wave lithotripsy.

Abstract:

:To investigate the roles of lithotripter shock wave (LSW) parameters and cavitation in stone comminution, a series of in vitro fragmentation experiments have been conducted in water and 1,3-butanediol (a cavitation-suppressive fluid) at a variety of acoustic field positions of an electromagnetic shock wave lithotripter. Using field mapping data and integrated parameters averaged over a circular stone holder area (R(h)=7 mm), close logarithmic correlations between the average peak pressure (P(+(avg))) incident on the stone (D=10 mm BegoStone) and comminution efficiency after 500 and 1000 shocks have been identified. Moreover, the correlations have demonstrated distinctive thresholds in P(+(avg)) (5.3 MPa and 7.6 MPa for soft and hard stones, respectively), that are required to initiate stone fragmentation independent of surrounding fluid medium and LSW dose. These observations, should they be confirmed using other shock wave lithotripters, may provide an important field parameter (i.e., P(+(avg))) to guide appropriate application of SWL in clinics, and facilitate device comparison and design improvements in future lithotripters.

journal_name

J Biomech

journal_title

Journal of biomechanics

authors

Smith N,Zhong P

doi

10.1016/j.jbiomech.2012.07.025

subject

Has Abstract

pub_date

2012-10-11 00:00:00

pages

2520-5

issue

15

eissn

0021-9290

issn

1873-2380

pii

S0021-9290(12)00437-X

journal_volume

45

pub_type

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