Pathomechanism of shock wave injuries on femoral artery, vein and nerve - An experimental study in dogs

Purpose: To study the pathomechanism of shock wave injuries to the femoral artery, vein and nerve in dogs. Materials and methods: High-energy shock wave (0.47 mJ/mm(2) energy flux density) were applied to the right femoral artery, vein and nerve in nine mongrels, and the left side was used as control. Macroscopic examinations including structure integrity, edema, discolouration and extravasation; and microscopic examinations including detachment of the intima layer, disruption of the medium layer, capillary congestion, neutrophil margination and extravasation of the outer layer and the surrounding tissues were performed in 2 h, and in 4 days, respectively, after shock wave application. Results: The most serious injuries included disruption of the medium layer with separation from the adventitia layer of the femoral artery. The injuries to the femoral vein and nerve predominantly involved the outer adventitia layer and the surrounding tissues. Mild nerve bundle swelling was noted in most cases. There were capillary congestion, neutrophil margination and extravasation indicative of inflammatory tissue reaction after shock wave application. Conclusion: High-energy shock waves caused serious injuries to the femoral artery, vein and nerve, especially the femoral artery and inflammatory reaction to the surrounding tissues. (C) 2002 Elsevier Science Ltd. All rights reserved.