title: 1pPAb5. Acoustic radiation force to reposition kidney stones.
abstract: Our group has introduced transcutaneous ultrasound to move kidney stones in order to expel small stones or relocate an obstructing stone to a nonobstructing location. Human stones and metalized beads (2-8 mm) were implanted ureteroscopically in kidneys of eight domestic swine. Ultrasonic propulsion was performed using a diagnostic imaging transducer and a Verasonics ultrasound platform. Stone propulsion was visualized using fluoroscopy, ultrasound, and the ureteroscope. Successful stone movement was defined as relocating a stone to the renal pelvis, ureteropelvic junction (UPJ) or proximal ureter. Three blinded experts evaluated for histologic injury in control and treatment arms. All stones were moved. 65% (17/26) of stones/beads were moved the entire distance to the renal pelvis (3), UPJ (2), or ureter (12). Average successful procedure per stone required 14±8 min and 23±16 pushes. Each push averaged 0.9 s in duration. Mean interval between pushes was 41±13 sec. No gross or histologic kidney damage was identified in six kidneys from exposure to 20 1-s pushes spaced by 33 s. Ultrasonic propulsion is effective with most stones being relocated to the renal pelvis, UPJ, or ureter. The procedure appears safe without evidence of injury.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bailey
authors.forename: Yak-Nam
authors.initials: YN
authors.lastname: Wang
authors.forename: Julianna
authors.initials: J
authors.lastname: Simon
authors.forename: Bryan
authors.initials: B
authors.lastname: Cunitz
authors.forename: Jonathan
authors.initials: J
authors.lastname: Harper
authors.forename: Ryan
authors.initials: R
authors.lastname: Hsi
authors.forename: Frank
authors.initials: F
authors.lastname: Starr
authors.forename: Marla
authors.initials: M
authors.lastname: Paun
authors.forename: Oleg
authors.initials: O
authors.lastname: Sapozhnikov
authors.forename: Barbrina
authors.initials: B
authors.lastname: Dunmire
authors.forename: Lawrence
authors.initials: L
authors.lastname: Crum
authors.forename: Mathew
authors.initials: M
authors.lastname: Sorensen