While some efforts have involved using dual shock wave delivery, the group from the University of Michigan has focused on combining two very different methodologies for stone fragmentation: electrohydraulic and cavitationally-based ultrasound (histotripsy).
In this in vitro proof-of-concept study, the authors used Ultracal-30 gypsum cement model stones placed on a 2 mm mesh screen. Combining electrohydraulic and ultrasonic modalities resulted in complete stone fragmentation to >2mm fragments in 16.7 minutes versus histotripsy (25.4 min.) or electrohydraulic shock wave lithotripsy (43.6 min. p <.001) alone. A significant challenge to the clinical relevance of cavitationally-based ultrasound will be the potential depth of penetration of this modality.
Presented by Alexander P. Duryea at the 29th World Congress of Endourology & SWL (WCE) - November 30 - December 3, 2011 - Kyoto International Conference Center - Kyoto, Japan
Reported for UroToday by Ralph V. Clayman, MD, Chair, Department of Urology, University of California-Irvine Medical Center, Irvine, CA
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