title: Ultrasonic propulsion of kidney stones: preliminary results of human feasibility study.
abstract: One in 11 Americans has experienced kidney stones, with a 50% average recurrence rate within 5-10 years. Ultrasonic propulsion (UP) offers a potential method to expel small stones or residual fragments before they become a recurrent problem. Reported here are preliminary findings from the first investigational use of UP in humans. The device uses a Verasonics ultrasound engine and Philips HDI C5-2 probe to generate real-time B-mode imaging and targeted "push" pulses on demand. There are three arms of the study:de novostones, post-lithotripsy fragments, and the preoperative setting. A pain questionnaire is completed prior to and following the study. Movement is classified based on extent. Patients are followed for 90 days. Ten subjects have been treated to date: threede novo, five post-lithotripsy, and two preoperative. None of the subjects reported pain associated with the treatment or a treatment related adverse event, beyond the normal discomfort of passing a stone. At least one stone was moved in all subjects. Three of five post-lithotripsy subjects passed a single or multiple stones within 1-2 weeks following treatment; one subject passed two (1-2 mm) fragments before leaving clinic. In the pre-operative studies we successfully moved 7 - 8 mm stones. In four subjects, UP revealed multiple stone fragments where the clinical image and initial ultrasound examination indicated a single large stone.
authors.affiliation: Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Bailey
authors.affiliation: Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Cunitz
authors.affiliation: Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, USA.
authors.forename: Barbrina
authors.initials: B
authors.lastname: Dunmire
authors.affiliation: Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, USA.
authors.forename: Marla
authors.initials: M
authors.lastname: Paun
authors.affiliation: Department of Urology, University of Washington, Seattle, USA.
authors.forename: Franklin
authors.initials: F
authors.lastname: Lee
authors.affiliation: Department of Urology, University of Washington, Seattle, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Ross
authors.affiliation: Department of Urology, Indiana University School of Medicine, Indianapolis, USA.
authors.forename: James
authors.initials: J
authors.lastname: Lingeman
authors.affiliation: Department of Urology, Baylor College of Medicine, Houston, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Coburn
authors.affiliation: Department of Urology, University of Washington, Seattle, USA.
authors.forename: Hunter
authors.initials: H
authors.lastname: Wessells
authors.affiliation: Department of Urology, University of Washington, Seattle, USA ; Division of Urology, Puget Sound Veteran Affairs Medical Center, Seattle, USA.
authors.forename: Mathew
authors.initials: M
authors.lastname: Sorensen
authors.affiliation: Department of Urology, University of Washington, Seattle, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Harper
keywords: clinical trial; kidney stone; shock wave lithotripsy; ultrasonic propulsion; ultrasound