Extracorporeal cardiac shock wave therapy (CSWT) also known as ESMR, is a new therapy which has been introduced recently to improve myocardial ischemia in a patient with severe CAD and refractory angina pectoris. Myocardial Revascularization using Shockwave technology (ESMR) is an effective an patient friendly modality for the stimulation of angiogenesis (formation of new blood vessels) and for treatment of patients with end stage Ischemic heard disease and resistant angina. This treatment is poised to become a more widely used treatment for the growing population of patients with end stage coronary heart disease.
It is technique based on using low intensity Shock waves, a form of sound waves similar to those generated by ultrasound machines produced by a special shock wave generator, targeted at the ischemic areas of heart muscles which stimulates the formation or growth of new blood vessels which in turn increases the blood supply to the ischemic area of the heart and improves its myocardial perfusion. Shock wave technology is already being used in the field of urology and orthopedics and now it’s being used in the field of cardiology for revascularization of reversible ischemic areas.
As the survival of patients with primary coronary events continues to increase, the number of patients presenting with coronary artery disease unsuitable to further revascularization techniques and symptoms refractory to medical therapy also continues to rise.
Who are the candidates for ESMR?
· Chronic chest pain (Refractory Angina) even after bypass surgery Angioplasty.
· Having 70-100 percent blockages in angiogram
· Chronic Renal disease with heart attack problem.
· High risk problems medically unfit for bypass surgery.
· Coronary anatomy not readily amenable for bypass surgery.
· Inability to perform angioplasty because the target lesion is inaccessible.
ESMR treatment is an excellent alternative for patients at an increased risk of requiring operative revascularization.