Evaluation of the Effects of Extracorporeal Shockwave Therapy in Patients With Peripheral Arterial Disease: A Meta-Analysis of Randomized Control Trials.

Abstract

The aim of this meta-analysis is to assess the efficacyof extracorporeal shockwave therapy (ESWT) in patients with peripheral arterial disease (PAD).This meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted independently by two authors using PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to January 15, 2023. Primary clinical outcomes assessed in this meta-analysis were changes in maximum waking distance (MWD) and pain-free walking distance (PFWD) from baseline. Other outcomes assessed included change in ankle brachial pressure index (ABI) and degree of arterial stenosis. Four RCTs involving a total of 228 patients were included. Change ofPFWD and MWD from baseline was significantly higher in patients randomized in the ESWT group as compared to the control group. No significant differences were reported between the two groups in terms of change in ABI from baseline. In conclusion, this meta-analysis of four randomized controlled trials found evidence that ESWTis an effective treatment for patients with PAD in terms ofimproving PFWD and MWD and reducing stenosis. However, there was no significant difference in the improvement of the ankle-brachial index between the study groups.