Extracorporeal Shockwave Therapy for the Treatment of Chronic Angina Pectoris

Exclusion Criteria

• •1. Patient has chronic lung disease based on the GOLD criteria the patient has stage IV: Very Severe COPD according to Spirometric Classification of COPD, Severity based on Post-Bronchodilator
• •2. Patient has emphysema and pulmonary fibrosis.
• •3. Patient has active endocarditis, myocarditis or pericarditis.
• •4. Patient is simultaneously participating in another device or drug study, or has participated in any clinical trial involving an experimental device or drug, including other drugs or devices enhancing cardiac neovascularization, or was treated with TMR (Transmyocardial revascularization) or PMR (Percutaneous revascularization) , or any ESWT machine for neovascularization of a competitor company within 3 months of entry into the study.
• •5. Patients who are unwilling or unable to cooperate with study procedure.
• •6. Patients who are unwilling to quit smoking during the study procedure (including screening phase)
• •7. Patients who had MI less than 3 months prior to treatment
• •8. Patients with moderately severe or severe valvular disease. Moderately-severe and severe disease will be echographically diagnosed as follows:
• •* Aortic Stenosis: Patients with Moderately-severe \[Peak Aortic valve gradient (AVG): 50-60 mmHg; Mean AVG: 30-40 mmHg; Effective orifice area (EOA): 0.75-1.0 cm2\] and severe Aortic Stenosis \[Peak AVG: above 60 mmHg; Mean AVG: above 40 mmHg; EOA: below 0.75 cm2\]
• •* Mitral Stenosis: Patients with severe Mitral Stenosis \[EOA: below 1 cm2; Pressure half-time (ms): above 200 mmHg; Mean Mitral valve gradient: above 10 mmHg\]
• •* Aortic Regurgitation \& Mitral Regurgitation: Patients with moderately- severe and severe aortic regurgitation and mitral regurgitation will be excluded.
• •* Moderately-severe (grade 3, or 3/4) and severe (grade 4, or 4/4) are hemodynamically significant.
• •* Tricuspid Regurgitation (TR): Its severity is graded from 1-4 as for aortic and mitral regurgitation. Grades 3 and 4 will be excluded from the study. The more severe levels of TR are common in severe biventricular failure, mitral stenosis, cor pulmunale and any other cause of pulmonary hypertension.
• •9. Patient with intraventricular thrombus
• •10. Patient is pregnant
• •11. Patient with a malignancy in the area of treatment