{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:11:47Z","timestamp":1782439907340,"version":"3.54.5"},"reference-count":43,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Maintaining ureteral patency is imperative to preventing renal injury and systemic infection. Ureteral stents are small conduits connecting the kidney and the bladder. They have been widely used to treat ureteral obstructions and ureteral leaks. The most problematic and frequent stent\u2010associated complication is stent encrustation. This occurs when mineral crystals (e.g. calcium, oxalate, phosphorus, struvite) are deposited onto the surface and internal lumen of the stent. Encrustation can lead to the obstruction of a stent and increases risk of systemic infection. As a result, ureteral stents need to be replaced typically every 2\u20133 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>In this study, we present a non\u2010invasive, high\u2010intensity focused ultrasound (HIFU)\u2010based technique to recanalize obstructed stents. By taking advantage of the mechanical force produced by a HIFU beam, including acoustic radiation force, acoustic streaming, and cavitation, HIFU can break up encrustations, clearing the stent of obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The ureteral stents for this study were obtained from patients undergoing ureteral stent removal. Under the guidance of ultrasound imaging, the encrustation in the stents were located, and then targeted by HIFU at frequencies of 0.25 and 1\u00a0MHz. The duty cycle of HIFU was 10%, and the HIFU burst repetition rate was 1\u00a0Hz, while the HIFU amplitude was varied to find the threshold pressure that would displace encrustations. The treatment duration was limited at 2 min (or 120 shots from HIFU). The treatments were carried out in two different orientations (parallel and perpendicular) of the ureteral stent with respect to the HIFU beam. For each setting, five treatments were conducted for a maximum duration of 2 min. During the entire treatment, an ultrasound imaging system was used to monitor the movement of encrustations inside the stent. The peak negative HIFU pressures needed to move the encrustations inside the stent was recorded for quantitative analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our results demonstrated that at both 0.25 and 1\u00a0MHz ultrasound frequencies, obstructed stents could be recanalized. At 0.25\u00a0MHz, the needed average peak negative pressure was 0.52\u00a0MPa in parallel orientation and 0.42\u00a0MPa in perpendicular orientation. At 1\u00a0MHz, the needed average peak negative pressure was 1.10\u00a0MPa in parallel orientation and 1.15\u00a0MPa in perpendicular orientation<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This first in\u2010vitro study has demonstrated the feasibility of non\u2010invasive HIFU to recanalize ureteral stents. This technology has a potential to reduce the need for ureteral stent exchange.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16447","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T07:59:30Z","timestamp":1683532770000},"page":"7349-7358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Recanalize ureteral stents with focused ultrasound"],"prefix":"10.1002","volume":"50","author":[{"given":"Rohit","family":"Singh","sequence":"first","affiliation":[{"name":"Institute for Bioengineering Research and Department of Mechanical Engineering University of Kansas  Lawrence Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhirup","family":"Samaddar","sequence":"additional","affiliation":[{"name":"Institute for Bioengineering Research and Department of Mechanical Engineering University of Kansas  Lawrence Kansas 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