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Shock waves generated by toroidal bubble collapse are imperative for kidney stone dusting during Holmium:YAG laser lithotripsy.

Publication ,  Journal Article
Xiang, G; Chen, J; Ho, D; Sankin, G; Zhao, X; Liu, Y; Wang, K; Dolbow, J; Yao, J; Zhong, P
Published in: Ultrasonics sonochemistry
December 2023

Holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy (LL) has been the treatment of choice for kidney stone disease for more than two decades, yet the mechanisms of action are not completely clear. Besides photothermal ablation, recent evidence suggests that cavitation bubble collapse is pivotal in kidney stone dusting when the Ho:YAG laser operates at low pulse energy (Ep) and high frequency (F). In this work, we perform a comprehensive series of experiments and model-based simulations to dissect the complex physical processes in LL. Under clinically relevant dusting settings (Ep = 0.2 J, F = 20 Hz), our results suggest that majority of the irradiated laser energy (>90 %) is dissipated by heat generation in the fluid surrounding the fiber tip and the irradiated stone surface, while only about 1 % may be consumed for photothermal ablation, and less than 0.7 % is converted into the potential energy at the maximum bubble expansion. We reveal that photothermal ablation is confined locally to the laser irradiation spot, whereas cavitation erosion is most pronounced at a fiber tip-stone surface distance about 0.5 mm where multi foci ring-like damage outside the thermal ablation zone is observed. The cavitation erosion is caused by the progressively intensified collapse of jet-induced toroidal bubble near the stone surface (<100 μm), as a result of Raleigh-Taylor and Richtmyer-Meshkov instabilities. The ensuing shock wave-stone interaction and resultant leaky Rayleigh waves on the stone surface may lead to dynamic fatigue and superficial material removal under repeated bombardments of toroidal bubble collapses during dusting procedures in LL.

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Published In

Ultrasonics sonochemistry

DOI

EISSN

1873-2828

ISSN

1350-4177

Publication Date

December 2023

Volume

101

Start / End Page

106649

Related Subject Headings

  • Organic Chemistry
  • Lithotripsy, Laser
  • Lasers, Solid-State
  • Kidney Calculi
  • Humans
  • Holmium
  • 4004 Chemical engineering
  • 3406 Physical chemistry
  • 0913 Mechanical Engineering
  • 0306 Physical Chemistry (incl. Structural)
 

Citation

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Xiang, G., Chen, J., Ho, D., Sankin, G., Zhao, X., Liu, Y., … Zhong, P. (2023). Shock waves generated by toroidal bubble collapse are imperative for kidney stone dusting during Holmium:YAG laser lithotripsy. Ultrasonics Sonochemistry, 101, 106649. https://doi.org/10.1016/j.ultsonch.2023.106649
Xiang, Gaoming, Junqin Chen, Derek Ho, Georgy Sankin, Xuning Zhao, Yangyuanchen Liu, Kevin Wang, John Dolbow, Junjie Yao, and Pei Zhong. “Shock waves generated by toroidal bubble collapse are imperative for kidney stone dusting during Holmium:YAG laser lithotripsy.Ultrasonics Sonochemistry 101 (December 2023): 106649. https://doi.org/10.1016/j.ultsonch.2023.106649.
Xiang G, Chen J, Ho D, Sankin G, Zhao X, Liu Y, et al. Shock waves generated by toroidal bubble collapse are imperative for kidney stone dusting during Holmium:YAG laser lithotripsy. Ultrasonics sonochemistry. 2023 Dec;101:106649.
Xiang, Gaoming, et al. “Shock waves generated by toroidal bubble collapse are imperative for kidney stone dusting during Holmium:YAG laser lithotripsy.Ultrasonics Sonochemistry, vol. 101, Dec. 2023, p. 106649. Epmc, doi:10.1016/j.ultsonch.2023.106649.
Xiang G, Chen J, Ho D, Sankin G, Zhao X, Liu Y, Wang K, Dolbow J, Yao J, Zhong P. Shock waves generated by toroidal bubble collapse are imperative for kidney stone dusting during Holmium:YAG laser lithotripsy. Ultrasonics sonochemistry. 2023 Dec;101:106649.
Journal cover image

Published In

Ultrasonics sonochemistry

DOI

EISSN

1873-2828

ISSN

1350-4177

Publication Date

December 2023

Volume

101

Start / End Page

106649

Related Subject Headings

  • Organic Chemistry
  • Lithotripsy, Laser
  • Lasers, Solid-State
  • Kidney Calculi
  • Humans
  • Holmium
  • 4004 Chemical engineering
  • 3406 Physical chemistry
  • 0913 Mechanical Engineering
  • 0306 Physical Chemistry (incl. Structural)