(CS-021) Extracorporeal Shockwave (ESWT) APPLICATION IN COMPLEX CASES – Revascularization of Chronic LL Wounds Mixed Etiologies.

Introduction: Medical conditions such as Ischaemia, vasculitis or a DVT can cause ILP, peripheral arterial disease (PAD). PAD is usually not an isolated vascular issue. The are numerous conditions for Lower Leg ulcers.

An important advantage in vascular medicine is revascularization to the ischemic tissues to improve blood flow, tissue oxygenation and pain. Studies suggest this procedure can prevent limb loss, promote wound healing, avoid amputation, and improve quality of life by rapidly improving refractory pain

Revascularization procedures are typically performed by a vascular surgeon and often requires inpatient hospitalization. Modalities and Innovative therapies have also shown benefit in revascularization and alleviating limb ischemia. The use of Extracorporeal Shockwave Therapy (ESWT) a treatment modality to accelerate the healing process shows evidence of immediate perfusion and improvement in oxygen saturation in a very short period after treatment.

Methods: Subjects were selected from the Vascular & Endovascular practice of the outpatient and in-patient setting at the Hospital Quinta D´Or - Rede D'Or São Luiz - RIO DE JANEIRO -BRAZIL



A cohort of 7 subjects consisting of 6 females and 1 male, various ages and etiologies were included in the evaluation. Standard of Care (SOC) was provided in combination performed at 1-week intervals (the appropriate number of shocks/treatments was relative to the wound bed area). The target wound was assessed and evaluated before each treatment session data and pictures were recorded.



Results: All 7 chronic wounds displayed a reduction of wound area over the study period, indicating that they were now on a healing trajectory. ESWT therapy seems to promote increased tissue oxygenation within the wound bed. Resulting in shorter healing time. No device-related adverse events occurred. There were no patient or investigator-reported complaints associated with receiving or providing ESWT therapy

Discussion: The results collaborate preceding research that suggest that ESWT therapy supports neovascularization and increases oxygen saturation levels in wounded tissues potentially facilitating a healing trajectory in chronic wounds of the lower extremity. ESWT can play a role in assisting with revascularization.