Document Detail


Evaluation of the LithoGold LG-380 Lithotripter: In Vitro Acoustic Characterization and Assessment of Renal Injury in the Pig Model.
MedLine Citation:
PMID:  23228113     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose: Conduct a laboratory evaluation of a novel low-pressure, broad focal zone electrohydraulic lithotripter (TRT LG-380). Methods: Mapping of the acoustic field of the LG-380, along with a Dornier HM3, a Storz Modulith SLX, and a XiXin CS2012 (XX-ES) lithotripter were performed using a fiber optic hydrophone. A pig model was used to assess renal response to 3,000 SWs administered by a multi-step power ramping protocol at 60 SW/min, and when animals were treated at the maximum power setting at 120 SW/min. Injury to the kidney was assessed by quantitation of lesion size and routine measures of renal function. Results: SW amplitudes for the LG-380 ranged from (P+/P-) 7/-1.8 MPa at PL-1 to 21/-4 MPa at PL-11 while focal width measured ~20 mm, wider than the HM3 (8 mm), SLX (2.6 mm) or XX-ES (18 mm). There was gradual narrowing of the focal width to ~10 mm after 5,000 SWs, but this had negligible effect on breakage of model stones, as stones positioned at the periphery of the focal volume (10 mm off-axis) broke nearly as well as stones at the target point. Kidney injury measured less than 0.1% FRV (functional renal volume) for pigs treated using a gradual power ramping protocol at 60 SW/min and when SWs were delivered at maximum power at 120 SW/min. Conclusions: The LG-380 exhibits the acoustic characteristics of a low-pressure, wide focal zone lithotripter and has the broadest focal width of any lithotripter yet reported. Although there was a gradual narrowing of focal width as the electrode aged, the efficiency of stone breakage was not affected. As injury to the kidney was minimal when treatment followed either the recommended slow SW-rate multi-step ramping protocol or when all SWs were delivered at fast SW-rate using maximum power, this appears to be a relatively safe lithotripter.
Authors:
Yuri A Pishchalnikov; James A McAteer; James Caldwell Williams; Bret A Connors; Rajash Handa; James E Lingeman; Andrew P Evan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-10
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Indiana University School of Medicine, Anatomy and Cell Biology, Indianapolis, Indiana, United States; yurapish@gmail.com.
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