What is Extracorporeal?

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Extracorporeal means outside the body (as opposed to intracorporeal or inside the body). 

Extracorporeal Shockwave Lithotripsy (ESWL) means the shockwave lithotripsy treatment occurs outside the body, and the healing waves are issued externally.

ESWL is an alternative treatment solution to surgery or ureteroscopy and laser stone fragmentation (URSL). ESWL is a therapeutic option for patients with gallstones, kidney and ureter stones (also called renal calculi, nephrolithiasis or urolithiasis), duct stones and bladder stones. For many patients, ESWL is the treatment of choice because they can avoid going under a knife or laser and excrete the calcified deposits naturally. For doctors, it’s also been the first-line treatment choice for most kidney and ureteral stones up to 20 mm in diameter.

Non-invasive treatment is a safe option during the COVID-19 pandemic. It’s low risk because it’s a short procedure and no overnight hospitalization, and exposure to a hospital setting is not required.

What is an extracorporeal shock wave therapy machine? 

An extracorporeal shock wave therapy machine is a medical device that is used outside of the body to treat a medical condition. This medical equipment was developed for extracorporeal shock wave lithotripsy and is a way to treat musculoskeletal disorders. In many cases, extracorporeal shockwave therapy machines are approved by CE and/or FDA.

What is Extracorporeal Shockwave for Myocardial Revascularization (ESMR)?

While the shockwave technology was first used for lithotripsy, it can also be applied in cardiology but at a different, lower intensity level. It’s typically called Low-intensity Extracorporeal Shockwave Treatment (Li-ESWT), one-tenth of the energy that goes into lithotripsy. Originally designed for a destructive procedure (crushing stones), Extracorporeal shockwave for myocardial revascularization (ESMR) is intended to trigger natural healing processes, improve myocardial perfusion, increase blood flow to the heart, and reduce symptoms of myocardial ischemia. ESMR is also known as non-invasive Cardiac Angiogenesis therapy (Ni-CATh).

In angiogenesis, new blood vessels are encouraged to grow and supply oxygen and nutrients to cardiac muscle. ESMR is a revolutionary therapy that enables some patients to avoid bypass surgery. For more sources of information, check here.

Extracorporeal shock wave therapy (a.k.a. ESWT) is any shockwave treatment that occurs outside of the body, rather than inside of the body. ESWT can be used to treat chronic plantar fasciitis, for example. Several research papers have estimated ESWT’s success rates to be as high as 80%, meaning the patient has normal function with some minor pain, or normal function without any pain at all.

Why Extracorporeal? 

Doctors and patients may consider the option of a non-invasive medical solution because it offers low risk and fewer complications than surgery, faster recovery time, and typically less pain than an invasive procedure. It’s a safe therapy with almost no reported side effects.

Extracorporeal versus Intracorporeal Faceoff

External  Internal
Non-surgical Laser or Surgery
Outpatient or Ambulatory In-patient
Short procedure and short treatment period Hospitalization overnight






  1. Extracorporeal shock wave therapy: an update ( 
  2. J Foot Ankle Surg. 2006 Jul-Aug;45(4):196-210. Extracorporeal shock wave therapy versus placebo for the treatment of chronic proximal plantar fasciitis: results of a randomized, placebo-controlled, double-blinded, multicenter intervention trial. Malay DS1, Pressman MM, Assili A, Kline JT, York S, Buren B, Heyman ER, Borowsky P, LeMay C.
  3. Role of Angiogenesis in Cardiovascular Disease | Circulation (
  4. Therapeutic angiogenesis in the heart – where do we stand today? (


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