Shockwave Therapy in Atherosclerosis

In this mini review recent developments in extracorporeal shockwave therapy (ESWT) within the field of atherosclerosis are discussed. Increased ecpression of growth factors such as endothelial nitric oxide (eNOS) and vascular endothelial growth factors (VGEFs) are induced by ESWT. IKL, integrin linked kinase, plays a key factor in this process of angiogenesis, believed to be responsible for the beneficial effects of ESWT. Both cardiac shock wave therapy (CWST) in chronic refractory angina pectoris patients as well as ESWT in patients with peripheral arterial disease (PAD) show a uniformly, consistent, beneficial effect in all studies available until now. International standardization of dose-response curves, doses applied, number of sessions and duration of treatment should be established at first, before starting large RCTs. With that knowledge the future of shockwave therapy in CAD and PAD seems bright.