Extracorporeal Shock Wave Therapy Improves the Walking Ability of Patients With Peripheral Artery Disease and Intermittent Claudication

Serizawa, Fukashi; Ito, Kei; Kawamura, Keiichiro; Tsuchida, Kozo; Hamada, Yo; Zukeran, Tsutomu; Shimizu, Takuya; Akamatsu, Daijiro; Hashimoto, Munetaka; Gotō, Hitoshi; Watanabe, Tetsuo; Sato, Akira; Shimokawa, Hiroaki; Satoh, Susumu

doi:10.1253/circj.cj-11-1216

Cited by 37 publications

(36 citation statements)

References 34 publications

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“…Based on the promising results in animal studies, we have developed the low-energy SW therapy, where the low-energy SW therapy improves symptoms and myocardial perfusion in patients with severe angina pectoris [5]–[8]. We also have demonstrated that the low-energy SW therapy improves the walking ability of patients with peripheral artery disease (PAD) and intermittent claudication [32]. Furthermore, we have recently demonstrated that the low-energy SW therapy induces therapeutic lymphangiogenesis, enhances skin wound healing and improves locomotor recovery after spinal cord injury [33]–[35].…”

Section: Discussionmentioning

confidence: 99%

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Low-Intensity Pulsed Ultrasound Induces Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Porcine Model of Chronic Myocardial Ischemia

et al. 2014

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BackgroundAlthough a significant progress has been made in the management of ischemic heart disease (IHD), the number of severe IHD patients is increasing. Thus, it is crucial to develop new, non-invasive therapeutic strategies. In the present study, we aimed to develop low-intensity pulsed ultrasound (LIPUS) therapy for the treatment of IHD.Methods and ResultsWe first confirmed that in cultured human endothelial cells, LIPUS significantly up-regulated mRNA expression of vascular endothelial growth factor (VEGF) with a peak at 32-cycle (P<0.05). Then, we examined the in vivo effects of LIPUS in a porcine model of chronic myocardial ischemia with reduced left ventricular ejection fraction (LVEF) (n = 28). The heart was treated with either sham (n = 14) or LIPUS (32-cycle with 193 mW/cm2 for 20 min, n = 14) at 3 different short axis levels. Four weeks after the treatment, LVEF was significantly improved in the LIPUS group (46±4 to 57±5%, P<0.05) without any adverse effects, whereas it remained unchanged in the sham group (46±5 to 47±6%, P = 0.33). Capillary density in the ischemic region was significantly increased in the LIPUS group compared with the control group (1084±175 vs. 858±151/mm2, P<0.05). Regional myocardial blood flow was also significantly improved in the LIPUS group (0.78±0.2 to 1.39±0.4 ml/min/g, P<0.05), but not in the control group (0.84±0.3 to 0.97±0.4 ml/min/g). Western blot analysis showed that VEGF, eNOS and bFGF were all significantly up-regulated only in the LIPUS group.ConclusionsThese results suggest that the LIPUS therapy is promising as a new, non-invasive therapy for IHD.

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Section: Discussionmentioning

confidence: 99%

“…We consider that this new LIPUS therapy should be first applied for patients with symptomatic angina pectoris without indication for PCI or CABG. The LIPUS therapy is also expected to be effective in PAD patients with intermittent claudication or refractory skin ulcer like the low-energy SW therapy [32]–[34].…”

Section: Discussionmentioning

confidence: 99%

Low-Intensity Pulsed Ultrasound Induces Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Porcine Model of Chronic Myocardial Ischemia

et al. 2014

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show abstract

“…Based on the promising results in animal studies, we have developed the low-energy SW therapy, where the low-energy SW therapy improves symptoms and myocardial perfusion in patients with severe angina pectoris [5]- [8]. We also have demonstrated that the low-energy SW therapy improves the walking ability of patients with peripheral artery disease (PAD) and intermittent claudication [32]. Furthermore, we have recently demonstrated that the low-energy SW therapy induces therapeutic lymphangiogenesis, enhances skin wound healing and improves locomotor recovery after spinal cord injury [33]- [35].…”

Section: Comparison Of Sw Therapy and Lipus Therapymentioning

confidence: 99%

Low-Intensity Pulsed Ultrasound Induces Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Porcine Model of Chronic Myocardial Ischemia

Hanawa

Ito

Aizawa

et al. 2012

Journal of Cardiac Failure

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“…Scintography demonstrated improved perfusion in dorsum of foot onlySmall sample size, non-randomised, short-term follow-upBelcaro G, Cesarone MR [25]Prospective non- randomised N = 326 sessions (3 times per week for 2 weeks) 1000 impulses per session, 0.08–0.43 mJ/mm 2 Improved pain-free walking distance , analogue scale for pain, laser Doppler skin perfusion, partial pressure of oxygen and decreased partial pressure of carbon dioxide. Reduced ORACLE scoreSmall sample size, non-randomised short-term follow-upSerizawa F, Ito K [26]Prospective non-randomised N = 129 sessions (3 times per week for 3 weeks) 40 spots per session with 200 impulses/spot 0.1 mJ/mm 2 Improved maximum walking distance , walking impairment questionnaire scores and shorter recovery timeSmall sample size, non-randomised, short-term follow-upSerizawa F, Ito K [26]Prospective non-randomised N = 66 sessions (3 times in first week (days 1, 3 and 5) and 3 sessions in week 5 (days 29, 31, 33) 40 spots per session with 200 impulses/spot 0.1 mJ/mm 2 The maximum walking distance was significantly increased at 4 weeks and 8 weeks follow-upSmall sample size, non-randomised, short-term follow-upData captured in italic are significant outcome for measures in the trial protocol …”

Section: Introductionmentioning

confidence: 99%

“…Finally a further two prospective non-randomised trials by Serizawa et al with a total of 6 patients and then 12 patients with Fontaine stage II PAD were treated with ESWT and demonstrated significantly improved maximum walking distance, shorter recovery time and improved walking impairment questionnaire scores [26]. …”

Section: Introductionmentioning

confidence: 99%

Extracorporeal shockwave therapy for the treatment of lower limb intermittent claudication: study protocol for a randomised controlled trial (the SHOCKWAVE 1 trial)

Cayton

Harwood

Smith

et al. 2017

Trials

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BackgroundPeripheral arterial disease (PAD) has a population prevalence of 4.6% with intermittent claudication (IC) presenting as one of the earliest and most common symptoms. PAD has detrimental effects on patients’ walking ability in terms of maximum walking distance (MWD) and pain-free walking distance (PFWD). Research has suggested extracorporeal shockwave therapy (ESWT) may induce angiogenesis in treated tissue; therefore, our objective is to assess the tolerability and efficacy of ESWT as a novel treatment of intermittent claudication.Methods/designPatients with unilateral claudication will be randomised to receive either ESWT (PiezoWave 2 shockwave system) or sham treatment to the calf muscle bulk three times per week for 3 weeks. All patients are blinded to treatment group, and all assessments will be performed by a masked assessor. Treatment tolerability using a visual analogue scale, ankle-brachial pressure index, MWD, PFWD and safety will all be formally assessed as outcome measures at baseline and at 4, 8 and 12 weeks follow-up.DiscussionThis trial will be the first of its kind in terms of methodology in relation to ESWT for intermittent claudication. A double-masked randomised controlled trial will provide useful information about the potential for the use of ESWT as a non-invasive treatment option and the need for further robust research.Trial registrationClinicalTrials.gov, NCT02652078. Registered on 17 October 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1844-4) contains supplementary material, which is available to authorized users.

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Extracorporeal Shock Wave Therapy Improves the Walking Ability of Patients With Peripheral Artery Disease and Intermittent Claudication

Cited by 37 publications

References 34 publications

Low-Intensity Pulsed Ultrasound Induces Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Porcine Model of Chronic Myocardial Ischemia

Low-Intensity Pulsed Ultrasound Induces Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Porcine Model of Chronic Myocardial Ischemia

Low-Intensity Pulsed Ultrasound Induces Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Porcine Model of Chronic Myocardial Ischemia

Extracorporeal shockwave therapy for the treatment of lower limb intermittent claudication: study protocol for a randomised controlled trial (the SHOCKWAVE 1 trial)

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