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Extracorporeal shock wave lithotripsy: interventional radiologic solutions to associated problems.

C J Tegtmeyer, C D Kellum, A Jenkins

    Radiology
    |December 1, 1986
    PubMed
    Summary

    Extracorporeal shock wave lithotripsy is effective for kidney stones. Larger stones (≥2.5 cm) may require interventions like nephrostomy due to obstruction from stone fragments.

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    Area of Science:

    • Urology
    • Interventional Radiology

    Background:

    • Extracorporeal shock wave lithotripsy (ESWL) is a common treatment for kidney stones.
    • Stone size is a critical factor influencing ESWL outcomes and potential complications.

    Purpose of the Study:

    • To evaluate the outcomes of ESWL based on stone size.
    • To identify the incidence and management of complications following ESWL.

    Main Methods:

    • Retrospective analysis of 1,500 patients treated with ESWL.
    • Categorization of patients based on stone diameter (<2.5 cm vs. ≥2.5 cm).
    • Documentation of all subsequent interventional radiologic procedures.

    Main Results:

    • 178 interventional procedures were performed across the patient cohort.

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  • Patients with larger stones (≥2.5 cm) had a higher incidence of urinary tract obstruction (29% required nephrostomy).
  • Only 1.8% of patients with smaller stones (<2.5 cm) required radiologic intervention.

    • Conclusions:

    • ESWL is generally safe and effective, but larger stones pose a higher risk of steinstrasse and obstruction.
    • Interventional radiology, including percutaneous nephrostomy, is crucial for managing complex cases, especially those with large stones and obstruction.