Design of a transducer for fragmenting large kidney stones using burst wave lithotripsy

Randad, Akshay; Ghanem, Mohamed A.; Bailey, Michael R.; Maxwell, Adam D.

doi:10.1121/2.0000954

Cited by 2 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Broad focus BWL transducers have been shown to break large artificial stones faster. 29 Conclusions A clinical BWL system comminuted 70% of human stones completely within 10 minutes under a range of conditions mimicking those in a human patient. The degree of comminution was effectively determined by applying ultrasonic propulsion to disperse the stone fragments under real-time ultrasound guidance.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Evaluation of Urinary Stone Comminution with a Clinical Burst Wave Lithotripsy System

Ramesh

Chen

Maxwell

et al. 2020

Journal of Endourology

Self Cite

View full text Add to dashboard Cite

Objective: Our goals were to validate stone comminution with an investigational burst wave lithotripsy (BWL) system in patient-relevant conditions and to evaluate the use of ultrasonic propulsion to move a stone or fragments to aid in observing the treatment endpoint. Materials and Methods: The Propulse-1 system, used in clinical trials of ultrasonic propulsion and upgraded for BWL trials, was used to fragment 46 human stones (5-7 mm) in either a 15-mm or 4-mm diameter calix phantom in water at either 50% or 75% dissolved oxygen level. Stones were paired by size and composition, and exposed to 20-cycle, 390-kHz bursts at 6-MPa peak negative pressure (PNP) and 13-Hz pulse repetition frequency (PRF) or 7-MPa PNP and 6.5-Hz PRF. Stones were exposed in 5-minute increments and sieved, with fragments >2 mm weighed and returned for additional treatment. Effectiveness for pairs of conditions was compared statistically within a framework of survival data analysis for interval censored data. Three reviewers blinded to the experimental conditions scored ultrasound imaging videos for degree of fragmentation based on stone response to ultrasonic propulsion. Results: Overall, 89% (41/46) and 70% (32/46) of human stones were fully comminuted within 30 and 10 minutes, respectively. Fragments remained after 30 minutes in 4% (1/28) of calcium oxalate monohydrate stones and 40% (4/10) of brushite stones. There were no statistically significant differences in comminution time between the two output settings ( p = 0.44), the two dissolved oxygen levels ( p = 0.65), or the two calyx diameters ( p = 0.58). Inter-rater correlation on endpoint detection was substantial (Fleiss' kappa = 0.638, p < 0.0001), with individual reviewer sensitivities of 95%, 86%, and 100%. Conclusions: Eighty-nine percent of human stones were comminuted with a clinical BWL system within 30 minutes under conditions intended to reflect conditions in vivo. The results demonstrate the advantage of using ultrasonic propulsion to disperse fragments when making a visual determination of breakage endpoint from the real-time ultrasound image.

show abstract

Section: Discussionmentioning

confidence: 99%

In Vitro Evaluation of Urinary Stone Comminution with a Clinical Burst Wave Lithotripsy System

Ramesh

Chen

Maxwell

et al. 2020

Journal of Endourology

Self Cite

View full text Add to dashboard Cite

show abstract

“…The first seven presentations, 7,8,[13][14][15][16][17] in the session are products of a single large NIH grant focused on one vision for the noninvasive surgical management of stones: an office-based, handheld ultrasound device to target, detach, break, and expel stones and stone fragments from the urinary space to facilitate natural clearance. The talks by authors of different expertise summarized the ongoing efforts to address the many different technical challenges of such an ambitious undertaking as well as described the significant progress toward its clinical implementation.…”

Section: Discussionmentioning

confidence: 99%

“…19 This paper extended and applied an understanding gained from work published in JASA 7 and elsewhere that beams broader than the stone diameter are more effective. 24 In the final presentation, Pishchalinikov et al used devices very similar to those in other presentations 7,8,[14][15][16][17] and focused on designing microbubbles to inject into the urinary space and attach to the stone to promote cavitation and stone fragmentation. 20 Several previous JASA papers, many by authors in this session, discussed erosion of stone surfaces by cavitation 6,7 and shielding of acoustic energy by bubbles between the source and the stone.…”

Section: Discussionmentioning

confidence: 99%

“…In reviewing the papers submitted, 7,8,[13][14][15][16][17][18][19][20] this session was the first in which every paper was directed to making new instruments to manage (particularly fragment) urinary stones. Although the fundamental science and advancement of scientific understanding remain, it is a shift that ASA researchers are now directly affecting the instruments used to treat patients or at least working in a direct line toward that goal.…”

Section: Session Overviewmentioning

confidence: 99%

See 1 more Smart Citation

Summary of “Biomedical Acoustics and Physical Acoustics: Shock Waves and Ultrasound for Calculus Fragmentation”

Simon

Bailey

2018

Proceedings of Meetings on Acoustics

Self Cite

View full text Add to dashboard Cite

This paper summarizes the special session, "Shock Waves and Ultrasound for Calculus Fragmentation," that took place during the 176th Meeting of the Acoustical Society of America and 2018 Acoustics Week in Canada. The sessions were cosponsored by the Biomedical Acoustics and Physical Acoustics Technical Committees and consisted of ten talks by industry and academic researchers from institutions in the United States, France, and the Russian Federation. The sessions described basic and applied acoustic research to manage urinary stones.

show abstract

Design of a transducer for fragmenting large kidney stones using burst wave lithotripsy

Cited by 2 publications

References 6 publications

In Vitro Evaluation of Urinary Stone Comminution with a Clinical Burst Wave Lithotripsy System

In Vitro Evaluation of Urinary Stone Comminution with a Clinical Burst Wave Lithotripsy System

Summary of “Biomedical Acoustics and Physical Acoustics: Shock Waves and Ultrasound for Calculus Fragmentation”

Contact Info

Product

Resources

About