Ku. Kohrmann et al., THE SHOCK-WAVE INDUCED VESSEL LESION IN T HE EX-VIVO MODEL OF THE ISOLATED-PERFUSED KIDNEY, Aktuelle Urologie, 25(5), 1994, pp. 298-304
Little is known about the mechanism and determining parameters of shoc
k wave induced kidney trauma. After classification of the renal lesion
in the in-vivo canine model, we developed an ex-vivo model using the
isolated perfused kidney of the pig that avoids unpredictable artefact
s and can be standardized. Kidneys from slaughtered pigs were isolated
and perfused by tyrode solution under physiological conditions. After
shock wave application on the Modulith SL 20 the vessel lesions were
evaluated by means of microangiography with respect to size and freque
ncy of dye paravasation in the different regions of the organ. The inf
luence of focusal localization within the kidney (capsule, cortex, cor
tico-medullar border, medulla-sinus), of the shock wave dosis (number
of shock waves, generator voltage) and of the perfusate (tyrode soluti
on, bariumsulphate suspension) were examined. Variations in focus loca
lization caused different patterns of lesions which characterized the
pathway of the shock wave. In particular, constant petechial paravasat
ion in the cortex was observed. Generator voltage correlated with the
diameter and frequency of the lesion area. The number of shock waves p
rimarily influenced the frequency of vessel rupture. In conclusion, it
was possible to evaluate localization and dose-dependency of the shoc
k wave-induced kidney trauma with high sensitivity and reproducibility
. Further advantages of the model are its easy availability and the fa
ct that studies on living animals are unnecessary. Thus, standardizati
on and comparison of different lithotripters become possible.