ESMR or Extracorporeal Shockwave Myocardial Revascularization is also known as Non invasive Cardiac Angiogenesis therapy (Ni-CATh). ESMR therapy is a new non invasive therapy approach which uses Extracorporeal Shockwave technology to improve the blood supply to heart muscles. This shockwave therapy causes new blood vessel formation in the heart improving myocardial vascularization. ESMR is latest in the treatment of coronary artery blockages. The conventional treatment of blocked coronary arteries is angioplasty and bypass surgery.
ESMR was developed by Essen Institute of Cardiology, Essen University, Germany.
The treatment is performed using a shock wave generator that is designed to address the unique Clinical-anatomical requirements of the chest cavity. A cardiac ultrasound imaging system is used to locate the treatment area and to map the exact position and extent of the ischemic zone. Shock waves are then delivered via the anatomical acoustic window to the treatment area under E.C.G. R-wave gating. Several treatment sessions are required to obtain optimal results.
The therapeutic effect of shock waves is attributed to the mechanical pressure and tension that the acoustic wave exerts on the cardiac tissue. Delivery of low intensity Shock waves causes sheer stress on the vessel wall. This stimulates angiogenesis related growth factors-( eNOS,VEGF and PCNA) initiating the angiogenesis process.
Angioplasty involves inserting and inflating a tiny balloon where your artery is clogged to help widen the artery temporarily. Angioplasty is often combined with the permanent placement of a stent (small wire mesh tube) to help keep the artery open and decrease the chance of the artery narrowing again. Some are drug-eluting stents which are coated with medication to help keep your artery open.
Bypass surgery or CABG is surgical treatment for Coronary Heart Disease. During CABG, a healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery. The graft artery or vein bypasses the blocked portion of the coronary artery. This creates a new path for blood to flow to the heart muscle. Surgeons will bypass multiple heart arteries during one surgery depending on the number of blocks.
Some patients who are not fit for bypass surgery or angioplasty or choose not to do it are on medical management for the relief of symptoms related to their heart disease.