Carey S W, Streem S B
Department of Urology, Cleveland Clinic Foundation, Ohio 44195.
J Urol. 1992 Jul;148(1):18-20. doi: 10.1016/s0022-5347(17)36496-0.
A total of 4 patients with renal or upper ureteral calculi associated with ipsilateral calcified renal arterial or abdominal aortic aneurysms underwent extracorporeal shock wave lithotripsy. One patient with a renal artery aneurysm had a solitary kidney. Linear distance from the calcified aneurysm to the stone, calculated by computerized and plain tomography, ranged between 4.6 and 6.5 cm. (mean 5.3). Treatment was accomplished on an unmodified Dornier HM3 lithotriptor using 900 to 2,400 shock waves (mean 1,575) at 18 kv. There were no complications of treatment and all 4 patients were discharged from the hospital within 24 hours, at which time radiographic examination revealed excellent stone comminution without change in the calcified aneurysm. With followup as long as 30 months, no adverse effects of therapy have become evident. We conclude that the presence of an ipsilateral calcified aneurysm may not necessarily preclude treatment of renal or upper ureteral calculi with extracorporeal shock wave lithotripsy, although further studies are required to help define the potential limits of such therapy in this setting.
共有4例患有肾或上段输尿管结石且伴有同侧钙化肾动脉或腹主动脉瘤的患者接受了体外冲击波碎石术。1例患有肾动脉瘤的患者为单肾。通过计算机断层扫描和平片断层扫描计算，钙化动脉瘤到结石的直线距离在4.6至6.5厘米之间（平均5.3厘米）。使用未改装的多尼尔HM3碎石机，在18千伏电压下施加900至2400次冲击波（平均1575次）完成治疗。治疗过程中无并发症发生，所有4例患者均在24小时内出院，此时影像学检查显示结石粉碎效果极佳，钙化动脉瘤无变化。随访长达30个月，未发现治疗的不良反应。我们得出结论，同侧钙化动脉瘤的存在不一定排除用体外冲击波碎石术治疗肾或上段输尿管结石，尽管需要进一步研究来明确这种治疗在这种情况下的潜在局限性。
