Low-Intensity Pulsed Ultrasound Therapy for Patients With Rutherford Stage 4 Peripheral Arterial Disease

Patients with severe peripheral artery disease (PAD) require improved vascular treatment options. This report discusses the cases of 2 patients with Rutherford stage 4 PAD who underwent treatment with low-intensity pulsed ultrasound (LIPUS). Patient 1 was a 74-year-old man diagnosed with atherosclerotic PAD. He had undergone multiple endovascular interventions since 2009 and experienced bilateral lower limb rest pain and sleep disturbance. Patient 2 was a 73-year-old woman, also diagnosed with atherosclerotic PAD associated with pseudoxanthoma elasticum. She reported bilateral rest pain in the lower extremities and limitations in activities of daily living. Although both patients had received conventional therapies, their symptoms did not improve. These cases were identified as "no-option" chronic limb-threatening ischemia for consideration of regenerative therapeutic approaches. After 1 month of LIPUS therapy, clinical symptoms improved in both patients. LIPUS therapy may be a safe and effective noninvasive treatment option for improving limb pain in the patients with no-option chronic limb-threatening ischemia.