TY - JOUR
T1 - Extracorporeal shock wave therapy improves the walking ability of patients with peripheral artery disease and intermittent claudication
AU - Serizawa, Fukashi
AU - Ito, Kenta
AU - Kawamura, Keiichiro
AU - Tsuchida, Ken
AU - Hamada, Yo
AU - Zukeran, Tsutomu
AU - Shimizu, Takuya
AU - Akamatsu, Daijiro
AU - Hashimoto, Munetaka
AU - Goto, Hitoshi
AU - Watanabe, Tetsuo
AU - Sato, Akira
AU - Shimokawa, Hiroaki
AU - Satomi, Susumu
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/6
Y1 - 2012/6
N2 - Background: Despite the recent advances in bypass surgery and catheter interventional therapy for peripheral artery disease (PAD), the long-term outcome of revascularization therapy for infrapopliteal lesions remains unsatisfactory. We have previously demonstrated that low-energy extracorporeal shock wave (SW) therapy effectively induces neovascularization through upregulation of angiogenic factors and improves myocardial ischemia in pigs and humans and in hindlimb ischemia in rabbits. In this study, we thus examined whether our SW therapy also improves the walking ability of patients with PAD and intermittent claudication. Methods and Results: We treated 12 patients (19 limbs) in Fontaine II stage (males/females, 10/2; 60-86 years old) with low-energy SW therapy to their ischemic calf muscle 3 times/week for 3 consecutive weeks. After 24 weeks, the pain and distance subscale scores of the walking impairment questionnaire were significantly improved (33±25 vs. 64±26, 27±16 vs. 64±23, respectively, both P<0.01). Maximum walking distance was also significantly improved at 4 weeks (151±37% from baseline, P<0.01) and was maintained at 24 weeks (180±74% from baseline, P<0.01). Moreover, the recovery time of the tissue oxygenation index in the calf muscle during a treadmill test, which reflects local O 2 supply, was significantly shortened (295±222 s vs. 146±137 s, P<0.01). Importantly, no adverse effects were noted. Conclusions: Non-invasive SW therapy improves the walking ability of PAD patients.
AB - Background: Despite the recent advances in bypass surgery and catheter interventional therapy for peripheral artery disease (PAD), the long-term outcome of revascularization therapy for infrapopliteal lesions remains unsatisfactory. We have previously demonstrated that low-energy extracorporeal shock wave (SW) therapy effectively induces neovascularization through upregulation of angiogenic factors and improves myocardial ischemia in pigs and humans and in hindlimb ischemia in rabbits. In this study, we thus examined whether our SW therapy also improves the walking ability of patients with PAD and intermittent claudication. Methods and Results: We treated 12 patients (19 limbs) in Fontaine II stage (males/females, 10/2; 60-86 years old) with low-energy SW therapy to their ischemic calf muscle 3 times/week for 3 consecutive weeks. After 24 weeks, the pain and distance subscale scores of the walking impairment questionnaire were significantly improved (33±25 vs. 64±26, 27±16 vs. 64±23, respectively, both P<0.01). Maximum walking distance was also significantly improved at 4 weeks (151±37% from baseline, P<0.01) and was maintained at 24 weeks (180±74% from baseline, P<0.01). Moreover, the recovery time of the tissue oxygenation index in the calf muscle during a treadmill test, which reflects local O 2 supply, was significantly shortened (295±222 s vs. 146±137 s, P<0.01). Importantly, no adverse effects were noted. Conclusions: Non-invasive SW therapy improves the walking ability of PAD patients.
KW - Angiogenesis
KW - Ischemia
KW - Peripheral artery disease
KW - Shock wave therapy
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U2 - 10.1253/circj.CJ-11-1216
DO - 10.1253/circj.CJ-11-1216
M3 - Article
C2 - 22447002
AN - SCOPUS:84861635490
VL - 76
SP - 1486
EP - 1493
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 6
ER -