Experience with EDAP LT02 extracorporeal shockwave lithotripsy in 1363 patients: comparison with results of LT01 SWL in 1586 patients.

A new piezoelectric lithotripter, the EDAP LT02, differs from the earlier LT01 in two important respects: a stone-localization system consisting of ultrasound and fluoroscopy and more energy per shockwave. The results of SWL monotherapy with the LT02 in 1363 patients and with the LT01 in 1586 patients who completed SWL treatment were compared. All of the stones could be localized by ultrasound (62.7%), fluoroscopy (0.3%), or both (37%) on the LT02, but the renal stones of three patients who had a history of open renal surgery and 29 upper ureteral stones could not be localized by real-time ultrasound on the LT01. The success rate (stone free or residual fragments < 4 mm in diameter) with the LT02 and LT01 according to stone location was not significantly different: 86.4% and 88.5%, respectively, for renal stones, 89.1% and 88.9% for ureteral stones, and 87.0% and 89.0% overall. The overall stone-free rate of LT02 and LT01 SWL was 78.8% and 87.9%, respectively. For mid-ureteral stones, the success rate with LT02 SWL was 76.8%. (Such stones were not an indication for LT01 SWL.) The mean number of treatment sessions with the LT02 (1.9) was much less (P < 0.001) than with the LT01 (3.3). The retreatment rates of LT02 and LT01 SWL were 68.2% and 198.2%, and the auxiliary treatment rates were 3.4% and 6.3%, respectively. Thus, the efficiency quotient was 45.9% in LT02 SWL, which was much higher than the 28.9% of the LT01. There was no significant difference in the occurrence of complications between LT02 and LT01 SWL. Therefore, LT02 piezoelectric lithotripsy is more efficient than the LT01 in localizing stones and can lessen the number of treatment sessions.