journal article·2024-04-01Open access

Accurate low-energy pulse system for intravascular lithotripsy

Jiacheng Ren, Qihui Shen, Jingzhen Shao, Ying Lin, Xu Liang

AIP Advances· Volume 14· Issue 4

Abstract

In response to biomedical imperatives, a novel approach is presented for the endovascular management of atherosclerosis. This approach is grounded in the electrohydraulic effect of a precisely controlled low-energy pulse discharge system, coupled with sequential control within the incomplete discharge electrode, to generate shockwaves aimed at softening blood vessels and rupturing calcified plaques. Theoretical analysis encompassed circuit design, control timing, and operational processes, while experimental investigations demonstrated precise control of non-oscillation and incomplete discharge by adjusting key parameters. Utilizing a 3 kV DC high-voltage power supply, a 220 nF capacitor, and two sets of 3.3 Ω resistors in parallel, with pin–plate electrodes as the load for discharge in normal saline, resulted in a 1 kV reduction in voltage across the capacitor and a peak current of 170 A. Energy release occurred through non-oscillatory and incomplete discharge, effectively generating shockwaves with peak pressures of 5–10 MPa at distances of 1–2 mm from the discharge center to treat calcified lesions. Compared with the existing intravascular lithotripsy devices, the shockwave system realizes accurate control of discharge energy by adjusting the turn-off time of incomplete discharge so as to realize accurate control of shockwave energy. Doctors can choose different intensities of shockwaves according to different degrees of calcification in the treatment process so as to minimize the discomfort caused by shockwaves and improve safety. Valuable insights are provided for intravascular lithotripsy devices in engineering.
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Research context

OpenAlex topics: Coronary Interventions and Diagnostics · Cardiac electrophysiology and arrhythmias · Cardiac pacing and defibrillation studies

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

University of Science and Technology of China 1 , Hefei 230026, China

Anhui Provincial Key Laboratory of Photonics Devices and Materials, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences 2 , Hefei 230031, China

Advanced Laser Technology Laboratory of Anhui Province 3 , Hefei 230037, China

Funding

Youth Innovation Promotion Association of the Chinese Academy of Sciences · Scientific Instrument Developing Project of the Chinese Academy of Sciences · Key Basic Research Projects of the Basic Strengthening Plan

References (33)

Show source-provided references
1. 1955
2. Experimental study on an alternative oil stimulation technique for tight gas reservoirs based on dynamic shock waves generated by Pulsed Arc Electrohydraulic Discharges10.1016/j.petrol.2012.01.009 ↗
3. Practical approaches to maximizing the resolution of sparker seismic reflection data10.1007/s11001-018-9367-2 ↗
4. Influence of some axially symmetric stepped forms of discharge chambers on the efficiency of electrohydraulic forming10.3103/s1068375519010113 ↗
5. Sterilization of solutions by underwater electric discharges10.1134/s0018143912030058 ↗
6. Pulse electrical discharges in water and their applications10.1063/1.1356742 ↗
7. Optimizing shock wave lithotripsy in the 21st century10.1016/j.eururo.2007.04.066 ↗
8. Shockwave lithotripsy: Anecdotes and insights10.1089/089277903770802191 ↗
9. Prevalence of subclinical coronary artery atherosclerosis in the general population10.1161/circulationaha.121.055340 ↗
10. The mechanism of balloon angioplasty10.1148/radiology.135.3.7384437 ↗
11. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease10.1056/nejm199408253310801 ↗
12. High-speed rotational atherectomy before paclitaxel-eluting stent implantation in complex calcified coronary lesions: The randomized ROTAXUS (rotational atherectomy prior to taxus stent treatment for complex native coronary artery disease) trial10.1016/j.jcin.2012.07.017 ↗
13. Prevention of no-reflow/slow-flow phenomenon during rotational atherectomy—A prospective randomized study comparing intracoronary continuous infusion of verapamil and nicorandil10.1016/j.ahj.2007.07.036 ↗
14. 2012 · 527
15. Safety and performance of lithoplasty for treatment of calcified peripheral artery lesions10.1016/j.jacc.2017.06.022 ↗
16. Safety and effectiveness of coronary intravascular lithotripsy for treatment of severely calcified coronary stenoses: The disrupt CAD II study10.1161/circinterventions.119.008434 ↗
17. Safety and feasibility of intravascular lithotripsy for treatment of common femoral artery stenoses10.1177/1526602819844998 ↗
18. Primary outcomes and mechanism of action of intravascular lithotripsy in calcified, femoropopliteal lesions: Results of disrupt PAD II10.1002/ccd.27943 ↗
19. Intravascular lithotripsy for treatment of severely calcified coronary artery disease10.1016/j.jacc.2020.09.603 ↗
20. Best practice in intravascular lithotripsy. Interventional cardiology: Reviews, research10.15420/icr.2021.14 ↗
21. Intravascular lithotripsy during percutaneous coronary intervention: Current concepts10.1080/14779072.2022.2069561 ↗
22. Evaluation of the safety and efficacy of coronary intravascular lithotripsy for treatment of severely calcified coronary stenoses: Evidence from the serial disrupt CAD trials10.3389/fcvm.2021.724481 ↗
23. Intravascular lithotripsy for vessel preparation in calcified coronary arteries prior to stent placement – Japanese disrupt CAD IV study 1-year results10.1253/circrep.cr-22-0068 ↗
24. Evaluation of safety and efficacy of coronary intravascular lithotripsy for treatment of severely calcified coronary stenoses: Design and rationale for the Disrupt CAD III trial10.1016/j.ahj.2020.04.005 ↗
25. Principles of intravascular lithotripsy for calcific plaque modification10.1016/j.jcin.2021.03.036 ↗
26. Investigative urology: Impact of shock wave pattern and cavitation bubble size on tissue damage during ureteroscopic electrohydraulic lithotripsy10.1016/s0022-5347(01)67734-6 ↗
27. Potential for cavitation-mediated tissue damage in shockwave lithotripsy10.1089/end.2007.9852 ↗
28. Energy transfer efficiency improvement of liquid pulsed current discharge by plasma channel length regulation method10.1109/tps.2017.2651105 ↗
29. Effect of electrical breakdown modes on shock wave intensity in water10.1109/tdei.2018.007027 ↗
30. Measurement of the waveform parameters of shallow explosive charges10.1121/1.392436 ↗
31. Development of subsonic electrical discharges in water and measurements of the associated pressure waves10.1088/0022-3727/39/24/021 ↗
32. Mechanism of the shock wave generation and energy efficiency by underwater discharge10.1260/1750-9548.6.2.89 ↗
33. Hydrodynamic modelling of transient cavities in fluids generated by high voltage spark discharges10.1088/0022-3727/39/22/011 ↗