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Kurt S et al, 2013: Evaluation of effects of Extracorporeal Shock Wave Lithotripsy on renal vasculature with Doppler ultrasonography

Kurt S, Tokgöz Ö, Tokgöz H, Voyvoda N
Zonguldak Atatürk Devlet Hastanesi, Department of Radiology,Zonguldak,Turkey


Abstract

OBJECTIVES: In this prospective study, we aimed to demonstrate the effects of Extracorporeal Shock Wave Lithotripsy (ESWL) on renal blood flow in patients treated for renal/ ureteral stones.

MATERIAL AND METHODS: The study group comprised 41 patients (26 males, 15 females, aged between 18-63 years, mean age 45 years), 23 with renal and 18 with ureteral stones, who underwent ESWL between March 2010 and January 2011. Colour Doppler ultrasonography and pulsed wave spectral analysis was performed before, 1 hour, and 7 days after ESWL to both ipsilateral and contralateral kidneys in order to measure resistive index (RI), pulsatility index (PI) and acceleration time (AT) values.

RESULTS: One hour after ESWL, RI and PI values showed significant increase from pre-ESWL values in both ipsilateral and contralateral kidneys. However, no significant change was found in AT values. Seven days after ESWL, PI in both ipsilateral and contralateral kidneys and RI in contralateral kidney returned to pre-ESWL values. But, 7 days after ESWL, RI in the ipsilateral kidney did not return to pre-ESWL values, although decreases in RI values were observed.

CONCLUSİON: Spectral Doppler analysis can provide valuable information as a non-invasive method to assess the hemodynamic changes and renal microcirculation status in cases managed with ESWL.

Med Ultrason. 2013 Dec;15(4):273-7.
PMID:24286090 [PubMed - in process]

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Comments 1

Hans-Göran Tiselius on Thursday, 21 November 2013 08:57

The effects of shockwaves on the renal perfusion have remained a matter of concern over the years despite the enormous experience of SWL. In this report both ipsilateral and contralateral resistive index and pulsatility index were significantly increased not only after SWL for renal stones but also following SWL of ureteral stones! The latter finding is surprising in view of the fact that some of the ureteral stones were located in the lower ureter and thus far away from the kidney. The demonstrated effects were transient and normalised after 7 days.

The clinical importance of these observations –if any – remains to be shown.

Hans-Göran Tiselius

The effects of shockwaves on the renal perfusion have remained a matter of concern over the years despite the enormous experience of SWL. In this report both ipsilateral and contralateral resistive index and pulsatility index were significantly increased not only after SWL for renal stones but also following SWL of ureteral stones! The latter finding is surprising in view of the fact that some of the ureteral stones were located in the lower ureter and thus far away from the kidney. The demonstrated effects were transient and normalised after 7 days. The clinical importance of these observations –if any – remains to be shown. Hans-Göran Tiselius
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Monday, 21 August 2017
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