(DLS-005) Extracorporeal Shockwave Therapy (ESWT) An Option for Pedal Arterial Ulcer(s) (PAU) with Standard of Care (SOC) Extracorporeal Shockwave Therapy (ESWT) An Option for Pedal Arterial Ulcer(s) (PAU) with Standard of Care (SOC)

Introduction: Pedal arterial ulcer(s) have poor perfusion. These pedal arterial ulcer(s) are deprived of oxygen thus leading to death of skin and skin structures thus developing a PAU.

Arterial Atherectomy is a treatment option to increase blood flow to the anoxic foot. More than 190,000 atherectomies are performed annually ⁽¹⁾. Success of atherectomies varies as surgical intervention does not guarantee healing for these PAU.

Patients with post atherectomy with PAU have few options if these ulcers remain stagnant or chronic. Amputation is usually recommended.

Introducing ESWT gives the physician/patient another treatment option.

Clinical observation and experience with ESWT has yielded + 95%, healing and improvement of the non-healing chronic arterial ulcers.

Before considering amputation as an option, in a stable PAU, ESWT should considered.

ESWT offers angiogenesis to the site of therapy improving micro-circulation to a poorly perfused pedal area.



Methods: Subjects were selected from the present wound care center. The criteria for the patients selected had post atherectomy non-healing pedal arterial ulcers. ESWT treatment therapy was applied during the course of three years (2019- to the present). Post atherectomies pedal artery ulcers were provided SOC: offloading, surgical debridement, with ESWT therapy. These patients demonstrated healing despite having recalcitrant pedal arterial ulcer(s). ESWT was performed once per week at 1000-1100 shocks per treatment, depending on ulcer size. These ulcers were measured by a third party that provided digital wound imaging, measurement, and wound assessment. ESWT advanced therapy was performed from 2019 to present

Results: ESWT therapy was well tolerated by patients. Seems that ESWT therapy may: decrease pain, decrease swelling, maintain optimal wound temperature, healing of 95% plus within six to eight weeks. Therapy protocol is 1 treatment session per week for a total of six to eight treatments.

Discussion: ESWT demonstrates a true, effective advanced therapy option post atherectomy recalcitrant pedal arterial ulcer. ESWT indicates improved quality life and may reduce the incidence of amputations.