{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:37:59Z","timestamp":1791200279025,"version":"4.2.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Vacuum-assisted ureteral access sheaths (V-UASs) are a new tool designed to evacuate dust or small fragments during retrograde intrarenal surgery (RIRS). There are reports of increased stone-free rates, decreased infections, and decreased operative time with V-UAS usage. The optimal technique and setting for V-UAS has yet to be described. Herein, we investigate real-time intrarenal pressure (IRP) throughout a range of settings using V-UAS in a porcine RIRS model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Ureteroscopy was performed in three female porcine cadaver kidneys through a ClearPetra V-UAS. IRP was recorded through a percutaneous catheter at different inflow pressures, sheath sizes, sheath distance from the ureteropelvic junction, and suction settings. Magnitude of change in delta IRP (dIRP) was compared at various settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There was no statistical difference in IRP when comparing no suction with vent inactivated. As expected, IRP decreased with larger sheath size and lower irrigation pressures. Average IRP dropped \u223c18\u2009mm Hg with suction activation (42.30\u2009mm Hg, vent inactivated; 24.45\u2009mm Hg IRP, suction activated;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Irrigation pressure and sheath size did not make a difference in the dIRP. dIRP was significantly greater at lower suction settings compared with max suction (25.44 dIRP at 200\u2009mm Hg suction, 10.26\u2009mm Hg dIRP at max suction,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04). In a subset of observations, IRP paradoxically increased to higher than IRP with no suction at all after &gt;5 seconds of activated suction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Use of V-UAS during RIRS can lower mean IRP; however, this effect could reverse with extended suctioning especially under conditions of high vacuum (&gt;200\u2009mm Hg) owing to outflow tract collapse. Our results suggest urologists should use lower suction settings and short, &lt;5-second bursts to maximize therapeutic benefit, and minimize potential shortcomings of V-UAS during RIRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2022.0573","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T12:59:53Z","timestamp":1668085193000},"page":"353-357","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Intrarenal Pressure with Vacuum-Assisted Ureteral Access Sheaths Using an\n                    <i>In Situ<\/i>\n                    Cadaveric Porcine Model"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6777-0980","authenticated-orcid":false,"given":"Adam","family":"Ostergar","sequence":"first","affiliation":[{"name":"Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6627-9409","authenticated-orcid":false,"given":"Daniel","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Shiang","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Ngo","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8726-0427","authenticated-orcid":false,"given":"Ramakrishna","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Sands","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,3,1]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-019-0489-x"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0090-4295(02)02440-8"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)66527-5"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2455-8"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2510-5"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9354714"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(17)36456-x"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2378-4"},{"issue":"6","key":"e_1_3_5_10_2","first-page":"438","article-title":"Pyelorenal backflow. Clinical and experimental investigations. Radiologic, nuclear, medical and pathoanatomic studies","volume":"31","author":"Thomsen HS","year":"1984","unstructured":"Thomsen HS. Pyelorenal backflow. Clinical and experimental investigations. Radiologic, nuclear, medical and pathoanatomic studies. Dan Med Bull, 1984; 31(6):438\u2013457.","journal-title":"Dan Med Bull"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-015-1114-4"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002610.07"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0090-4295(02)01861-7"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/089277904322836631"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8052013"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2022.0004"}],"container-title":["Journal of Endourology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/end.2022.0573","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2022.0573","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2022.0573","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:14:53Z","timestamp":1777407293000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/end.2022.0573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1089\/end.2022.0573"],"URL":"https:\/\/doi.org\/10.1089\/end.2022.0573","relation":{},"ISSN":["0892-7790","1557-900X"],"issn-type":[{"value":"0892-7790","type":"print"},{"value":"1557-900X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}