title: Therapeutic Ultrasound Promotes Reperfusion and Angiogenesis in a Rat Model of Peripheral Arterial Disease.
abstract: BACKGROUND
  Shock wave therapy (SWT) is an acoustic technology clinically used for the non-invasive treatment of ischemic heart disease (IHD). Therapeutic ultrasound (TUS) has more recently been developed for the same indication, although its effects on reperfusion and angiogenesis have yet to be directly compared to those of SWT.
  
  
  RESULTS
  TUS and SWT acoustic parameters were matched, and their ability to promote angiogenesis and reperfusion in a rat hindlimb ischemia model was compared. After left femoral artery excision, 3-weekly TUS, SWT or sham treatments (n=10 rats each) of the left hindlimb were performed for 2 weeks. Laser Doppler perfusion imaging demonstrated improved perfusion with TUS (66±4% L:R hindlimb perfusion, mean±SEM, P=0.02), but not with SWT (59±4%, P=0.13) compared with sham (50±4%). Immunohistochemistry of CD31 demonstrated increased microvascular density with TUS (222.6 vessels/high-power field, P=0.001) and SWT (216.9, P=0.01) compared to sham-treated rats (196.0). Tissue vascular endothelial growth factor mRNA levels were elevated in the left hindlimb of TUS-, but not SWT- or sham-treated rats.
  
  
  CONCLUSIONS
  Direct comparison demonstrates that TUS is more effective than SWT at promoting reperfusion, whereas both therapies promote angiogenesis in ischemic gastrocnemius muscle. These results suggest that TUS may be more effective than SWT for the treatment of IHD and peripheral arterial disease.
authors.affiliation: Cardiovascular Research Institute, University of California San Francisco.
authors.forename: Babak
authors.initials: B
authors.lastname: Nazer
authors.forename: Farzin
authors.initials: F
authors.lastname: Ghahghaie
authors.forename: Risa
authors.initials: R
authors.lastname: Kashima
authors.forename: Tatiana
authors.initials: T
authors.lastname: Khokhlova
authors.forename: Camilo
authors.initials: C
authors.lastname: Perez
authors.forename: Lawrence
authors.initials: L
authors.lastname: Crum
authors.forename: Tom
authors.initials: T
authors.lastname: Matula
authors.forename: Akiko
authors.initials: A
authors.lastname: Hata
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D019220:High-Energy Shock Waves; D018919:Neovascularization, Physiologic; D058729:Peripheral Arterial Disease / Q000503:physiopathology / Q000628:therapy; D026741:Physical Therapy Modalities; D051381:Rats; D017207:Rats, Sprague-Dawley