Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects.
Identifieur interne : 000426 ( PubMed/Corpus ); précédent : 000425; suivant : 000427Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects.
Auteurs : Richard L. Blackmon ; Pierce B. Irby ; Nathaniel M. FriedSource :
- Journal of biomedical optics [ 1560-2281 ] ; 2011.
English descriptors
- KwdEn :
- MESH :
- chemical : Calcium Oxalate, Thulium.
- chemistry : Urinary Calculi.
- methods : Lithotripsy, Laser.
- therapeutic use : Lasers, Solid-State.
- therapy : Urinary Calculi.
- Humans, In Vitro Techniques, Optical Fibers, Optical Phenomena, Phantoms, Imaging.
Abstract
The holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but efficient operation is limited to low pulse rates (∼10 Hz) during lithotripsy. On the contrary, the thulium fiber laser (TFL) is limited to low pulse energies, but can operate efficiently at high pulse rates (up to 1000 Hz). This study compares stone ablation threshold, ablation rate, and retropulsion for the two different Ho:YAG and TFL operation modes. The TFL (λ = 1908 nm) was operated with pulse energies of 5 to 35 mJ, 500-μs pulse duration, and pulse rates of 10 to 400 Hz. The Ho:YAG laser (λ = 2120 nm) was operated with pulse energies of 30 to 550 mJ, 350-μs pulse duration, and a pulse rate of 10 Hz. Laser energy was delivered through 200- and 270-μm-core optical fibers in contact mode with human calcium oxalate monohydrate (COM) stones for ablation studies and plaster-of-Paris stone phantoms for retropulsion studies. The COM stone ablation threshold for Ho:YAG and TFL measured 82.6 and 20.8 J∕cm(2), respectively. Stone retropulsion with the Ho:YAG laser linearly increased with pulse energy. Retropulsion with TFL was minimal at pulse rates less than 150 Hz, then rapidly increased at higher pulse rates. For minimal stone retropulsion, Ho:YAG operation at pulse energies less than 175 mJ at 10 Hz and TFL operation at 35 mJ at 100 Hz is recommended, with both lasers producing comparable ablation rates. Further development of a TFL operating with both high pulse energies of 100 to 200 mJ and high pulse rates of 100 to 150 Hz may also provide an alternative to the Ho:YAG laser for higher ablation rates, when retropulsion is not a primary concern.
DOI: 10.1117/1.3564884
PubMed: 21806249
Links to Exploration step
pubmed:21806249Le document en format XML
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Fried</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2011">2011</date><idno type="doi">10.1117/1.3564884</idno><idno type="RBID">pubmed:21806249</idno><idno type="pmid">21806249</idno><idno type="wicri:Area/PubMed/Corpus">000426</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000426</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects.</title><author><name sortKey="Blackmon, Richard L" sort="Blackmon, Richard L" uniqKey="Blackmon R" first="Richard L" last="Blackmon">Richard L. Blackmon</name><affiliation><nlm:affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Irby, Pierce B" sort="Irby, Pierce B" uniqKey="Irby P" first="Pierce B" last="Irby">Pierce B. Irby</name></author><author><name sortKey="Fried, Nathaniel M" sort="Fried, Nathaniel M" uniqKey="Fried N" first="Nathaniel M" last="Fried">Nathaniel M. Fried</name></author></analytic><series><title level="j">Journal of biomedical optics</title><idno type="eISSN">1560-2281</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Calcium Oxalate</term><term>Humans</term><term>In Vitro Techniques</term><term>Lasers, Solid-State (therapeutic use)</term><term>Lithotripsy, Laser (methods)</term><term>Optical Fibers</term><term>Optical Phenomena</term><term>Phantoms, Imaging</term><term>Thulium</term><term>Urinary Calculi (chemistry)</term><term>Urinary Calculi (therapy)</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Calcium Oxalate</term><term>Thulium</term></keywords><keywords scheme="MESH" qualifier="chemistry" xml:lang="en"><term>Urinary Calculi</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lithotripsy, Laser</term></keywords><keywords scheme="MESH" qualifier="therapeutic use" xml:lang="en"><term>Lasers, Solid-State</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Urinary Calculi</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>In Vitro Techniques</term><term>Optical Fibers</term><term>Optical Phenomena</term><term>Phantoms, Imaging</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but efficient operation is limited to low pulse rates (∼10 Hz) during lithotripsy. On the contrary, the thulium fiber laser (TFL) is limited to low pulse energies, but can operate efficiently at high pulse rates (up to 1000 Hz). This study compares stone ablation threshold, ablation rate, and retropulsion for the two different Ho:YAG and TFL operation modes. The TFL (λ = 1908 nm) was operated with pulse energies of 5 to 35 mJ, 500-μs pulse duration, and pulse rates of 10 to 400 Hz. The Ho:YAG laser (λ = 2120 nm) was operated with pulse energies of 30 to 550 mJ, 350-μs pulse duration, and a pulse rate of 10 Hz. Laser energy was delivered through 200- and 270-μm-core optical fibers in contact mode with human calcium oxalate monohydrate (COM) stones for ablation studies and plaster-of-Paris stone phantoms for retropulsion studies. The COM stone ablation threshold for Ho:YAG and TFL measured 82.6 and 20.8 J∕cm(2), respectively. Stone retropulsion with the Ho:YAG laser linearly increased with pulse energy. Retropulsion with TFL was minimal at pulse rates less than 150 Hz, then rapidly increased at higher pulse rates. For minimal stone retropulsion, Ho:YAG operation at pulse energies less than 175 mJ at 10 Hz and TFL operation at 35 mJ at 100 Hz is recommended, with both lasers producing comparable ablation rates. Further development of a TFL operating with both high pulse energies of 100 to 200 mJ and high pulse rates of 100 to 150 Hz may also provide an alternative to the Ho:YAG laser for higher ablation rates, when retropulsion is not a primary concern.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">21806249</PMID><DateCreated><Year>2011</Year><Month>08</Month><Day>02</Day></DateCreated><DateCompleted><Year>2012</Year><Month>01</Month><Day>05</Day></DateCompleted><DateRevised><Year>2014</Year><Month>11</Month><Day>20</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1560-2281</ISSN><JournalIssue CitedMedium="Internet"><Volume>16</Volume><Issue>7</Issue><PubDate><Year>2011</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Journal of biomedical optics</Title><ISOAbbreviation>J Biomed Opt</ISOAbbreviation></Journal><ArticleTitle>Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects.</ArticleTitle><Pagination><MedlinePgn>071403</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1117/1.3564884</ELocationID><Abstract><AbstractText>The holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but efficient operation is limited to low pulse rates (∼10 Hz) during lithotripsy. On the contrary, the thulium fiber laser (TFL) is limited to low pulse energies, but can operate efficiently at high pulse rates (up to 1000 Hz). This study compares stone ablation threshold, ablation rate, and retropulsion for the two different Ho:YAG and TFL operation modes. The TFL (λ = 1908 nm) was operated with pulse energies of 5 to 35 mJ, 500-μs pulse duration, and pulse rates of 10 to 400 Hz. The Ho:YAG laser (λ = 2120 nm) was operated with pulse energies of 30 to 550 mJ, 350-μs pulse duration, and a pulse rate of 10 Hz. Laser energy was delivered through 200- and 270-μm-core optical fibers in contact mode with human calcium oxalate monohydrate (COM) stones for ablation studies and plaster-of-Paris stone phantoms for retropulsion studies. The COM stone ablation threshold for Ho:YAG and TFL measured 82.6 and 20.8 J∕cm(2), respectively. Stone retropulsion with the Ho:YAG laser linearly increased with pulse energy. Retropulsion with TFL was minimal at pulse rates less than 150 Hz, then rapidly increased at higher pulse rates. For minimal stone retropulsion, Ho:YAG operation at pulse energies less than 175 mJ at 10 Hz and TFL operation at 35 mJ at 100 Hz is recommended, with both lasers producing comparable ablation rates. Further development of a TFL operating with both high pulse energies of 100 to 200 mJ and high pulse rates of 100 to 150 Hz may also provide an alternative to the Ho:YAG laser for higher ablation rates, when retropulsion is not a primary concern.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Blackmon</LastName><ForeName>Richard L</ForeName><Initials>RL</Initials><AffiliationInfo><Affiliation>University of North Carolina at Charlotte, Department of Physics and Optical Science, 9201 University City Avenue, Charlotte, North Carolina 28223-0001, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Irby</LastName><ForeName>Pierce B</ForeName><Initials>PB</Initials></Author><Author ValidYN="Y"><LastName>Fried</LastName><ForeName>Nathaniel M</ForeName><Initials>NM</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D013486">Research Support, U.S. Gov't, Non-P.H.S.</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Biomed Opt</MedlineTA><NlmUniqueID>9605853</NlmUniqueID><ISSNLinking>1083-3668</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>2612HC57YE</RegistryNumber><NameOfSubstance UI="D002129">Calcium Oxalate</NameOfSubstance></Chemical><Chemical><RegistryNumber>8RKC5ATI4P</RegistryNumber><NameOfSubstance UI="D013932">Thulium</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D002129">Calcium Oxalate</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D066298">In Vitro Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D053844">Lasers, Solid-State</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000627">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D017602">Lithotripsy, Laser</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D055100">Optical Fibers</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D055620">Optical Phenomena</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D019047">Phantoms, Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013932">Thulium</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D014545">Urinary Calculi</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000737">chemistry</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000628">therapy</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>8</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>8</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2012</Year><Month>1</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="doi">10.1117/1.3564884</ArticleId><ArticleId IdType="pubmed">21806249</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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