Low-energy extracorporeal shock wave therapy, preclinical and clinical studies

Abstract

Floyd Dunn’s extensive research career contributed significantly to safety and efficacy of diagnostic and therapeutic ultrasound. Positive effects of low-energy shock wave therapy (SWT) show preclinical promise in renal disease in pigs and in cardiovascular disease in humans. Preclinical: a set of 26 pigs were divided into four groups, normal + SWT, atherosclerotic renal artery stenosis (ARAS) + SWT, and Normal and ARAS pigs. After three weeks of ARAS or sham, SWT was applied twice a week for three weeks. SWT after ARAS decreased blood pressure, recovered the stenotic microvascular density, improved renal blood flow and glomerular filtration rate, and decreased fibrosis. No noticeable kidney injury was observed. Low-energy SWT recovers the stenotic kidney toward normal function by preserving intra-renal microcirculation and may also alleviate renovascular hypertension. 72 patients with refractory angina, 43 were treated with low-energy SWT in the area peripheral to their infarct and 29 patients were in the control group. No adverse effects were seen in the treated group. At six months post-treatment angina class score was decreased (p = 0.0002), nitroglycerine use was reduced (p = 0.03), and hospitalization rate was reduced (p = 0.03). Low-energy shockwave therapy may be a tool for treating diseases caused by ischemia.