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Ann Vasc Surg. 2016 Aug;35:226-33. doi: 10.1016/j.avsg.2016.02.017. Epub 2016 Jun 14.

A Systematic Review of Extracorporeal Shockwave Therapy as a Novel Treatment for Intermittent Claudication.

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Academic Vascular Surgery Unit, University of Hull, Hull York Medical School, Hull, UK. Electronic address:
Academic Vascular Surgery Unit, University of Hull, Hull York Medical School, Hull, UK.



Extracorporeal shockwave therapy (ESWT) is emerging as a potential new treatment option for a variety of clinical scenarios including promotion of wound healing and symptom control in end-stage ischemic heart disease. A number of small trials have investigated ESWT in the management of peripheral arterial disease (PAD). A systematic review of the literature was performed investigating the efficacy and potential mechanism of action of ESWT for PAD.


A systematic review was conducted using MEDLINE and PubMed databases in keeping with the standard reporting guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis group to identify any publications relating to the use of ESWT in PAD.


Systematic literature review identified 5 studies in 4 articles investigating ESWT in the treatment of symptomatic PAD. Although participant numbers within the identified studies were small, significant improvements in pain-free walking distance and maximum walking distance were demonstrated. The mechanism of action is thought to be due to mechanotransduction and subsequent angiogenesis.


ESWT shows promise as a potentially efficacious novel treatment for symptomatic PAD. However, studies to date are small and record heterogeneous outcomes. Appropriately powered, randomized, sham-controlled data including objective clinical outcomes to comprehensively assess the efficacy of this novel treatment modality is still required before determining if ESWT should be brought into routine clinical practice.

[Indexed for MEDLINE]

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