Abstract 11650: Non-Invasive Extracorporeal Shock Wave Therapy Ameliorates Walking Ability of 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, for which up-regulation of vascular endothelial growth factor and endothelial NO synthase is involved. The aim of this study was to examine whether our low-energy SW therapy is also effective to ameliorate walking ability of patients with peripheral artery disease (PAD) and intermittent claudication.
Methods: We enrolled 12 patients who were classified in the stage of Fontaine II (10 men and 2 women, 60-86 years old; 10 with arteriosclerosis obliterans, one with Buerger disease, and one with polyarteritis nodosa). Based on our previous works, one SW session consisted of 200 shots in each 40 spots in the ischemic calf muscle at 0.023-0.054 mJ/mm2, an energy level of <10% of that used for lithotripsy therapy. We performed the low-energy SW therapy 3 times per week for 3 consecutive weeks.
Results: The maximum walking distance was significantly increased at 4 weeks (151±37% from baseline, P<0.01), and the beneficial effect of the low-energy SW therapy was sustained at 8 weeks (161±56% from baseline, P<0.01), 12 weeks (171±74% from baseline, P<0.01), and 24 weeks (183±76% from baseline, P<0.01). The distance sub-scale score of walking impairment questionnaire was also significantly increased (26±15 at baseline vs. 64±23 at 24 weeks, P<0.01). Moreover, the recovery time of O2Hb/cHb ratio in calf muscle that reflects local micro-circulation during tread-mill test was significantly improved (327±237 sec at baseline vs. 157±143 sec at 24 weeks, P<0.01). Importantly, no procedural complications or adverse effects were noted.
Conclusion: These results indicate that our non-invasive low-energy SW therapy ameliorates walking ability of PAD patients without any adverse effects.
- © 2011 by American Heart Association, Inc.