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Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter.

Publication ,  Journal Article
Neisius, A; Smith, NB; Sankin, G; Kuntz, NJ; Madden, JF; Fovargue, DE; Mitran, S; Lipkin, ME; Simmons, WN; Preminger, GM; Zhong, P
Published in: Proc Natl Acad Sci U S A
April 1, 2014

The efficiency of shock wave lithotripsy (SWL), a noninvasive first-line therapy for millions of nephrolithiasis patients, has not improved substantially in the past two decades, especially in regard to stone clearance. Here, we report a new acoustic lens design for a contemporary electromagnetic (EM) shock wave lithotripter, based on recently acquired knowledge of the key lithotripter field characteristics that correlate with efficient and safe SWL. The new lens design addresses concomitantly three fundamental drawbacks in EM lithotripters, namely, narrow focal width, nonidealized pulse profile, and significant misalignment in acoustic focus and cavitation activities with the target stone at high output settings. Key design features and performance of the new lens were evaluated using model calculations and experimental measurements against the original lens under comparable acoustic pulse energy (E+) of 40 mJ. The -6-dB focal width of the new lens was enhanced from 7.4 to 11 mm at this energy level, and peak pressure (41 MPa) and maximum cavitation activity were both realigned to be within 5 mm of the lithotripter focus. Stone comminution produced by the new lens was either statistically improved or similar to that of the original lens under various in vitro test conditions and was significantly improved in vivo in a swine model (89% vs. 54%, P = 0.01), and tissue injury was minimal using a clinical treatment protocol. The general principle and associated techniques described in this work can be applied to design improvement of all EM lithotripters.

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Published In

Proc Natl Acad Sci U S A

DOI

EISSN

1091-6490

Publication Date

April 1, 2014

Volume

111

Issue

13

Start / End Page

E1167 / E1175

Location

United States

Related Subject Headings

  • Sus scrofa
  • Skin
  • Respiration
  • Motion
  • Lithotripsy
  • Lenses
  • Female
  • Equipment Design
  • Electromagnetic Phenomena
  • Animals
 

Citation

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Neisius, A., Smith, N. B., Sankin, G., Kuntz, N. J., Madden, J. F., Fovargue, D. E., … Zhong, P. (2014). Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter. Proc Natl Acad Sci U S A, 111(13), E1167–E1175. https://doi.org/10.1073/pnas.1319203111
Neisius, Andreas, Nathan B. Smith, Georgy Sankin, Nicholas John Kuntz, John Francis Madden, Daniel E. Fovargue, Sorin Mitran, et al. “Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter.Proc Natl Acad Sci U S A 111, no. 13 (April 1, 2014): E1167–75. https://doi.org/10.1073/pnas.1319203111.
Neisius A, Smith NB, Sankin G, Kuntz NJ, Madden JF, Fovargue DE, et al. Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter. Proc Natl Acad Sci U S A. 2014 Apr 1;111(13):E1167–75.
Neisius, Andreas, et al. “Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter.Proc Natl Acad Sci U S A, vol. 111, no. 13, Apr. 2014, pp. E1167–75. Pubmed, doi:10.1073/pnas.1319203111.
Neisius A, Smith NB, Sankin G, Kuntz NJ, Madden JF, Fovargue DE, Mitran S, Lipkin ME, Simmons WN, Preminger GM, Zhong P. Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter. Proc Natl Acad Sci U S A. 2014 Apr 1;111(13):E1167–E1175.
Journal cover image

Published In

Proc Natl Acad Sci U S A

DOI

EISSN

1091-6490

Publication Date

April 1, 2014

Volume

111

Issue

13

Start / End Page

E1167 / E1175

Location

United States

Related Subject Headings

  • Sus scrofa
  • Skin
  • Respiration
  • Motion
  • Lithotripsy
  • Lenses
  • Female
  • Equipment Design
  • Electromagnetic Phenomena
  • Animals