The Impact of Extracorporeal Shock Wave Therapy on Microcirculation in Diabetic Feet: A Pilot Study

Abstract

BACKGROUND: Patients with diabetic foot commonly experience vascular insufficiency and compromised tissue perfusion. Extracorporeal shockwave therapy (ESWT) reportedly promotes wound healing and angiogenesis, but clinical studies on the effect of ESWT on angiogenesis are scarce and the exact mechanism remains unclear. OBJECTIVE: To investigate the effect of ESWT on cutaneous microcirculation in diabetic feet. METHODS: Ten patients with diabetic feet received ESWT twice weekly for a total of six sessions. Transcutaneous partial oxygen pressure (Tcpo(2)) and cutaneous blood flow were measured before and after ESWT. MAIN RESULTS: The treated feet showed statistically significant improvements in the mean Tcpo(2) (P < .01) and cutaneous blood flow level (P < .05) compared with control feet. In treated feet, Tcpo(2) increased by 19.6%, from 41.4 +/- 9.9 to 49.5 +/- 8.7 mm Hg (P < .05). In control feet, Tcpo(2) decreased by 11.6%, from 39.5 +/- 14.0 to 34.9 +/- 14.5 mm Hg (P = .059). The average cutaneous blood flow level of treated feet before ESWT was 36.9 +/- 25.6, which increased to 48.3 +/- 32.4 AU after ESWT (30.9% increase; P = .646). In control feet, the cutaneous blood flow level decreased from 80.5 +/- 36.7 to 60.4 +/- 38.8 AU, a decrease of 25.0% (P = .241). CONCLUSIONS: These results demonstrate that ESWT may have beneficial effects on microcirculation in diabetic feet.