Treatment time reduction using tandem shockwaves for lithotripsy: an in vivo study

Area of Science:

• Biomedical Engineering
• Urology
• Nephrology

Background:

• Previous attempts to shorten extracorporeal shockwave lithotripsy (SWL) by increasing shockwave rate proved ineffective.
• Research indicates that higher shockwave rates are not clinically viable for kidney stone treatment.

Purpose of the Study:

• To evaluate the efficacy of tandem shockwaves in reducing SWL treatment time.
• To determine if tandem shockwaves can significantly decrease treatment duration without compromising stone fragmentation efficiency.

Main Methods:

• An animal model (rabbits) with implanted artificial kidney stones was used.
• A tandem research lithotripter delivered standard single-pulse and tandem shockwaves.
• Treatments were conducted with and without a fluid-filled expansion chamber surrounding the stones.

Main Results:

• Fluid surrounding the stone improved fragmentation in both standard and tandem SWL modes.
• No significant difference in fragmentation efficiency was observed between standard and tandem SWL when fluid was present.
• Tandem shockwaves reduced treatment time by 50% when stones were surrounded by fluid.

Conclusions:

• Tandem shockwaves offer a potential method for significantly reducing SWL treatment times.
• Future clinical applications may involve using tandem shockwaves for urinary stones immersed in fluid.