Microcirculatory response to shock wave therapy in ischemia reperfusion – preliminary report.

Background: Despite success in clinical application, exact mechanism of shock wave therapy (ESWT) remains unknown. We hypothesized that ESWT induces ingrowth and neovascularization and improves blood supply to tissues. Objective: To asses effect of shock wave therapy on flap hemodynamics and leuckocyte‐endothelial interactions under ischemic conditions. Material and methods: Following cremaster muscle dissection, 118 Lewis rats are randomly divided into 7 groups: Non‐ischemic baseline controls; 2h ischemia control; 5h ischemia control; ESWT before 2h ischemia; ESWT before 5h ischemia; ESWT after 2h ischemia; ESWT after 5h ischemia. After surgical dissection rats ESWT is applied at 0.10 mJ/mm2 in dose of 200 and 500 impulses. Hemodynamics Parameters: Microcirculatory measurements (number of rolling, sticking and transmigrating leukocytes in postcapillary venule, functional capillary index and RBC velocity) are recorded at 1,2,3,4 hours after cremaster dissection in group 1 and after ischemia and ESWT in study groups. Micropermeability Index: Endothelial micropermeability (EMP) is measured following injection of FITC‐albumin. Immunofluorescence images analysis of albumin are taken in 15min intervals for 1h after reperfusion. Endothelial Micropermeability Index is calculated as interstitial/intraluminal pixels ratio. Results: Preliminary results showed that 200 impulses do not alter significantly microcirculatory heamodynamics whereas 500 impulses increase permeability index Conclusions: These results confirm that microcirculatory response to ESWT are dose dependent.