Strategies for Improved Shock Wave Lithotripsy

改进冲击波碎石术的策略

• 批准号: 7279975
• 负责人: ANDREW P EVAN
• 金额: $ 124.7万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-05-10 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7279975
• 关键词: Strategies; Improved; Shock; Wave; Lithotripsy

During our last funding period, we have helped the lithotripsy community recognize the severity of SWL adverse effects, and we have made a significant contribution to the understanding of the physical acoustic mechanisms of shock wave action involved in stone comminufion and tissue injury. However, from our perspective in this field we see there is still much that needs to be accomplished. In particular, the urology community is now faced with a new dilemma, in that lithotripsy is not getting better and the lithotripter itself has become a risk factor. Our multidisplanary team of scientist/clinicians is ideally situated to address these issues. The present renewal proposal has developed a plan of four interactive, collaborative projects to achieve the following goals. We will: 1. Identify and isolate factors that increase the risk of adverse effects in SWL. 2. Define the tissue response to SW's that leads to long-term renal damage. 3. Develop treatment strategies (protective mechanisms) that reduce the renal trauma suffered during lithotripsy. 4. Establish criteria for the selection of SW parameters (rate, voltage, number) for safe and effective SWL. 5. Evaluate the efficacy and safety of 3rd generation electromagnetic lithotripters, as a step toward determining how to improve SWL performed with these devices. 6. Develop real-time imaging and cavitation detection to allow the urologist to monitor tissue damage and stone comminution during SWL. 7. Test a new concept in SW delivery (dual pulse lithotripsy) for cavitation control to enhance stone breakage and minimize tissue injury. 8. Determine the mechanics of stone failure in SWL so that the lithotripter waveform can be perfected for efficient stone breakage. 9. Establish computational models that will simulate the critical features of shock wave action (the virtual lithotripter) and allow relevant predictions for systematic improvement of SWL. Our main goal is to improve shock wave lithotripsy - to make lithotripsy safer and more efficient for all patients.

在我们上一个资助期间，我们帮助碎石界认识到SWL不良反应的严重性，我们对冲击波作用在结石粉碎和组织损伤中的物理声学机制的理解做出了重大贡献。然而，从我们在这一领域的角度来看，我们看到仍有许多事情需要完成。特别是泌尿外科现在面临着一个新的困境，那就是碎石术并没有变得更好，而碎石机本身已经成为一个危险因素。我们的多学科科学家/临床医生团队处于解决这些问题的理想位置。目前的更新建议制定了四个互动合作项目的计划，以实现以下目标。我们将: