Cavitation effects during lithotripsy. Part I. Results of in vitro experiments

Cavitation effects and microbubble formation are due to the rarefactive (negative pressure) component of shock waves. The in vitro application of shock waves generated by a commercial lithotriptor to an anthropomorphic phantom showed that stone fragmentation occurred more completely in fluid media that support cavitation than in a solid agar-graphite gel. Various fluids (saline, iodinated contrast material, bile) supported different degrees of cavitation. Bile exhibited cavitation at low energy and gave rise to intense microbubble formation at 19 kV. Cavitation increased dramatically with an increase in the rate of generation from 1.0 to 1.8 shock waves per second. The authors conclude that during biliary lithotripsy the environment of a stone will influence the extent of cavitation and fragmentation.