Abstract 14942: Non-Invasive Extracorporeal Shock Wave Therapy Ameliorates Walking Ability in Patients with Peripheral Artery Disease and Intermittent Claudication
Background: We have previously demonstrated that low-energy extracorporeal shock wave (SW) therapy effectively induces neovascularization and improves myocardial ischemia in pigs and humans as well as hindlimb ischemia in rabbits through up-regulation of vascular endothelial growth factor and endothelial NO synthase. The aim of this study was to examine whether our low-energy SW therapy is also effective to ameliorate walking ability in patients with peripheral artery disease (PAD) and intermittent claudication.
Methods and Results: We performed 2 clinical trials with 12 patients who were classified in the stage of Fontaine II. Based on our previous works, one SW session consisted of 200 shots in each 40 spots in the ischemic calf muscle at 0.004–0.054 mJ/mm2, an energy level of <10% of that used for lithotripsy therapy. In the first trial, we treated 6 patients (5 men and 1 woman, 67–82 years old, all patients with arteriosclerosis obliterans) with our low-energy SW therapy 3 times per week in the first (day 1, 3, 5) and fifth weeks (day 29, 31, 33). The maximum walking distance (MWD) at 4 and 8 weeks was increased from baseline (0 week), but they were gradually decreased after 12 weeks. Therefore, in the second trial, we treated another 6 patients (all man, 60–86 years old, 5 with arteriosclerosis obliterans and one with Buerger disease) with low-energy SW therapy 3 times per week for 3 consecutive weeks. In this second trial, MWD was significantly increased at 4 weeks (166±6% from baseline, P=0.04), and the beneficial effect of the low-energy SW therapy was sustained at 8 weeks (153±5% from baseline, P=0.03) and 12 weeks (163±6% from baseline, P=0.02) and 24 weeks (156±12% from baseline, P=0.0X). Importantly, no procedural complications or adverse effects were noted during the follow up period.
Conclusions: These results indicate that our non-invasive low-energy SW therapy ameliorates walking ability in PAD patients without any adverse effects.
- © 2010 by American Heart Association, Inc.