Effects of Shock Waves on Microcirculation, Perfusion, and Pain Management in Critical Limb Ischemia

• Published in: Angiology 2005-07, Vol.56 (4), p.403-407
• Main Authors: Belcaro, G., Cesarone, M. R., Dugall, M., Di Renzo, A., Errichi, B. M., Cacchio, M., Ricci, A., Stuard, S., Ippolito, E., Fano, F., Theng, A., Kasai, M., Hakim, G., Acerbi, G.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; High-Energy Shock Waves - therapeutic use; Hormones. Endocrine system; Humans; Ischemia - physiopathology; Ischemia - therapy; Leg - blood supply; Male; Medical sciences; Microcirculation; Pain Management; Pharmacology. Drug treatments; Vasodilator agents. Cerebral vasodilators
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/000331970505600407

Shock waves (SW) are used to control pain in different clinical conditions (eg, painful knee, elbow, and shoulder, etc). The effects of SWs may be due to cellular “stunning” (particularly nervous components). It may also be the consequence of unknown metabolic actions on tissues, which may include changes in cellular permeability, the liberation of proteins and mediators locally acting on pain and nerve endings. The aim of this study was to evaluate the reduction in pain and the improvement in microcirculation induced by SW treatment in a 2-week study in patients with chronic limb ischemia (CLI). Of the 32 patients with CLI, 30 (20 with rest pain only, 10 with necrosis) completed the study. The treatment was well tolerated. Foot radiographs performed before and after treatment indicate no bone damage after treatment. Foot (tibial arteries) blood pressure was unchanged after 2 weeks. The increase in laser Doppler flux was significant (p