Extracorporeal shock wave therapy ameliorates secondary lymphedema by promoting lymphangiogenesis Masayuki Kubo, PhD, Tao-Sheng Li, MD, PhD, Takahiro.

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Extracorporeal shock wave therapy ameliorates secondary lymphedema by promoting lymphangiogenesis Masayuki Kubo, PhD, Tao-Sheng Li, MD, PhD, Takahiro Kamota, MD, Mako Ohshima, PhD, Bungo Shirasawa, MD, PhD, Kimikazu Hamano, MD, PhD Journal of Vascular Surgery Volume 52, Issue 2, Pages 429-434 (August 2010) DOI: 10.1016/j.jvs.2010.03.017 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 The effect of shock wave (SW) treatment on lymphedema. A, Measurement of ear thickness showed that the SW group had significantly thinner skin than the control group 4 weeks after treatment. *P < .05 vs control group (n = 7/group). Mean data are presented with the standard error of the mean. B, Representative histologic images for the SW-treated and untreated (control) lymphedematous ear 4 weeks after treatment. Bars indicate 1000 μm (upper panels, original magnification ×20) and 100 μm (lower panels, original magnification ×200; hematoxylin and eosin stain). Journal of Vascular Surgery 2010 52, 429-434DOI: (10.1016/j.jvs.2010.03.017) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 Analysis of vascular endothelial growth factor (VEGF)-C expression in skin tissue 4 weeks after shock wave (SW) treatment. A, Representative images of Western blot analysis for VEGF-C. B, Quantification after normalization to β-actin showed that the expression of VEGF-C was significantly higher in the SW group than in the control group. *P < .05 vs control group (n = 4/group). Mean data are presented with the standard error of the mean. Journal of Vascular Surgery 2010 52, 429-434DOI: (10.1016/j.jvs.2010.03.017) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Analysis of vascular endothelial growth factor receptor 3 (VEGFR3) expression in skin tissue 4 weeks after shock wave (SW) treatment. A, Representative images of Western blot analysis for VEGFR3. B, Quantification after normalization to β-actin revealed significantly higher expression of VEGFR3 in the SW group than in the control group. *P < .05 vs control group (n = 4/group). Mean data are presented with the standard error of the mean. Journal of Vascular Surgery 2010 52, 429-434DOI: (10.1016/j.jvs.2010.03.017) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 Histologic analysis of the lymphatic vessels in the lymphedematous ear 4 weeks after shock wave (SW) treatment. A, Representative images of immunostaining for vascular endothelial growth factor receptor 3 (VEGFR3; arrows). Bars indicate 50 μm (original magnification ×400). B, Quantification analysis revealed significantly increased density of the lymphatic vessels in the SW group compared with the control group. *P < .05 vs. control group (n = 3/group). Mean data are presented with the standard error of the mean. Journal of Vascular Surgery 2010 52, 429-434DOI: (10.1016/j.jvs.2010.03.017) Copyright © 2010 Society for Vascular Surgery Terms and Conditions