Abstract: A lithotripsy system can include a lithotripsy device and controller circuitry. The device for acoustic calculi fracture can include an acoustic treatment probe for providing acoustic energy along the probe to treat one or more calculi and an evacuation pathway extending at least partially via the prob, for removing at least a portion of the one or more calculi via the evacuation pathway. The controller circuitry, coupled to the lithotripsy device, can be configured to receive an indication of clogging of the evacuation pathway and at least one of initiate or adjust a anti-clogging mode for changing at least one characteristic of evacuation via the evacuation pathway in response to the received indication of clogging.