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Pretreatment with low-energy shock waves induces vasoconstriction during standard SWL: A treatment protocol known to reduce lithotripsy-induced renal injury
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This article provides a suggestion that vasoconstriction plays a role in the SWL 'protection protocol, in press
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Handa RK, Bailey MR, Paun M, et al. Pretreatment with low-energy shock waves induces vasoconstriction during standard SWL: a treatment protocol known to reduce lithotripsy-induced renal injury. BJU Int 2008 (in press). This article provides a suggestion that vasoconstriction plays a role in the SWL 'protection protocol'.
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PMCID-66301. A demonstration that a 3-4 min pause following delivery of an initial dose of shock waves is critical to the 'protection protocol, in press
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Connors BA, Evan AP, Blomgren PM, et al. Effect of initial shock wave voltage on shock wave lithotripsy-induced lesion size during step-wise voltage ramping. BJU Int (in press). PMCID-66301. A demonstration that a 3-4 min pause following delivery of an initial dose of shock waves is critical to the 'protection protocol'.
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Evan AP, McAteer JA, Connors BA, et al. Renal injury in SWL is significantly reduced by slowing the rate of shock wave delivery. BJU Int 2007; 100:624-627. This report of research with the pig model shows that slowing the shock wave rate to 30 shock waves/min virtually eliminates the acute renal injury seen with a dose of 2000 shock waves. In a follow-up study recently submitted for publication, it has been observed that treatment at 60 shock waves/min is also protective.
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Semins MJ, Track BJ, Matlaga BR. The effect of shock wave rate on the outcome of shock wave lithotripsy: a meta-analysis. J Urol 2008; 179: 194-197. This critical meta-analysis supports the findings of several prospective clinical trials (see [24-26]) reporting improved stone breakage outcomes when the firing rate of the lithotripter is slowed to 60 shock waves/min.
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In-vitro survey of protocols commonly used to couple the lithotripter to the patient, showing that typical procedures of applying lithotripsy gel are ineffective and highly variable and that simple techniques can be used to significantly improve the quality of coupling
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Neucks JS, Pishchalnikov YA, Zancanaro AJ, et al. Improved acoustic coupling for shock wave lithotripsy. Urol Res 2008; 36:61-66. In-vitro survey of protocols commonly used to couple the lithotripter to the patient, showing that typical procedures of applying lithotripsy gel are ineffective and highly variable and that simple techniques can be used to significantly improve the quality of coupling.
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