Abstract
In Japan, aging of the population and Westernization of lifestyle lead to increased morbidity of atherosclerotic diseases. Especially, the prognosis for patients with critical limb ischemia complicated with diabetes mellitus is poor and lower limb amputation is needed in some of those patients. We have previously reported that low-energy extracorporeal shock wave (SW) therapy induces neovascularization, and improves myocardial ischemia in a pig model of chronic myocardial ischemia and in patients with severe angina pectoris, without any adverse effects. We also reported that the SW therapy improves walking ability in patients with peripheral arterial disease and intermittent claudication (Fontaine stage II) and that the SW therapy facilitate wound healing in a mouse model of skin ulcer. Thus, the low-energy extracorporeal SW therapy appears to be an effective, safe, and non-invasive angiogenic approach in cardiovascular medicine and its indication could be extended to refractory critical limb ischemia (Fontaine stage III and IV).
