Extracorporeal Shock Wave Lithotripsy for Patients with Calcified Ipsilateral Renal Arterial or Abdominal Aortic Aneurysms

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Abstract
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.