Connors BA et al, 2018: Preliminary Report on Stone Breakage and Lesion Size Produced by a New Extracorporeal Electrohydraulic (Sparker Array) Discharge Device.
Connors BA, Schaefer RB, Gallagher JJ, Johnson CD, Li G, Handa RK, Evan AP.
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN.
Phoenix Science and Technology, Goffstown, NH.
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN.
School of Physics, Northeast Normal University, Changchun, China.
Abstract
OBJECTIVE: To determine if an innovative extracorporeal electrohydraulic shock wave device (sparker array) can effectively fracture artificial stones in vitro and in vivo, and if sparker array treatment produces a renal lesion in our pig model of lithotripsy injury. Results of these experiments will be used to help evaluate the suitability of this device as a clinical lithotripter.
METHODS: Utracal-30 artificial stones were placed in a holder at the focus of the sparker array and treated with 600 shock waves (21.6 kV, 60 shocks/min). Stone fragments were collected, dried and weighed to determine stone breakage. In vivo stone breakage entailed implanting stones into pigs. These stones were treated with 600 or 1200 shock waves and the fragments collected for analysis. Lesion analysis consisted of treating the left kidney of pigs with 1200 or 2400 shock waves and quantitating the hemorrhagic lesion.
RESULTS: In vitro, 71±2% of each artificial stone was fractured to < 2 mm in size. In vivo stone breakage averaged 63%. Renal injury analysis revealed that only 1 out of 7 kidneys showed evidence of hemorrhagic injury in the treated area.
CONCLUSIONS: The sparker array consistently comminuted artificial stones demonstrating its ability to fracture stones like other lithotripters. Also, the sparker array caused little to no renal injury at the settings used in this study. These findings suggest further research is warranted to determine the potential of this device as a clinical lithotripter.
Urology. 2018 Mar 26. pii: S0090-4295(18)30275-9. doi: 10.1016/j.urology.2018.03.020. [Epub ahead of print]. FREE ARTICLE
Comments 1
This article describes a new and interesting technique for stone disintegration.
The technique is based on a sparker array arrangement that was used by replacing the original therapy head of a Dornier Compact S lithotripter. The device comprised 27 (3 x 9) sparker units.
Both in vitro and in vivo animal experiments showed promising results with a good level of disintegration without (or possibly with minor) tissue effects.
The further development of this project will be interesting to follow in order to find out if this new technology is better than existing systems.