In cases with no significant change in patient angina, how is it possible to ensure therapy was provided as it does not have an immediate effect?

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One should distinguish between technical and operational malfunction and unfavorable patient characteristics when analyzing the results. In order to reduce the chance for a malfunction, the user has to make sure the following:  

  • The shockwaves are generating sound when triggered.  
  • No presence of air bubble inside the SWA.
  • The SWA was used within its guaranteed lifespan.
  • The membrane is with full contact with patient skin with no wrinkles. 
  • Ultrasound gel (without air bubbles) is used and is covering completely the SWA membrane part that is in contact with patient skin.
  • Applying shockwaves at the same area during the same week, and changing it during the next week of treatments.
  • Allowing 3 weeks between weeks of treatments, in order not to destroy the delicate vasculature that is created, when applying new shockwaves as the same region.  

Some patient characteristics may also alter the effect, such as previous or on-going smoking or diabetes. With diabetic patients, there might be a need for repeated sessions to achieve therapeutic effect. So far, a success rate of 70% was reported. 

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