[Spinal electrostimulation in the treatment of advanced chronic obliterating arteriopathies].
From 1989 to 1992 83 patients suffering from peripheral vascular disease without medical or surgical possibilities, were treated by spinal cord stimulation (SCS). We studied claudicatio intermittens, rest pain and ischemic lesion behaviour in all the patients. We also studied microcirculation behaviour of 21 patients, by oxygen transcutaneous tension (vasodilatation index VI = TcPO2 42 degrees C: TcPO2 45 degrees C) and laser Doppler flowmetry (resting flow RF, standing flow SF, venoarteriolar reflex VAR = RF - SF, flow temperature increase FTI = F 40 degrees C 15'-RF). The clinical follow-up at 2 years showed an improvement of walking distance in 85.7% of 7 controls, a complete rest pain control in 82.35% of 17 controls, an improvement and healing of ischemic lesions respectively in 27.07% and 53.86% of 18 controls. In arteriosclerotic arteriopathy with or without diabetes but without neuropathy VI increased and FTI decreased, after SCS, showing a sympathetic tone decrease. In arteriosclerotic arteriopathy with diabetic neuropathy V.I. decreased and FTI increased, after SCS, showing a sympathetic tone reappearance. VAR improved or reappeared, in arteriosclerotic arteriopathy with or without diabetes, showing improvement of tissue perfusion as regards a better efficiency of "paramicrovessels" and "microvascular unit". We believe that SCS, as regards favourable clinical results represents a useful and effective treatment in peripheral vascular disease treatment.
Visconti
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Centro di Chirurgia Vascolare, Reparto di Chirurgia Generale, Ospedale, G.B. Giustinian, Venezia.
Fontana
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Buonocore
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P
Grillo
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N
Seno
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S
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000628:therapy*; D001785:Blood Gas Monitoring, Transcutaneous; D002908:Chronic Disease; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000628:therapy; D017078:Laser-Doppler Flowmetry; D007866:Leg / Q000098:blood supply*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D013116:Spinal Cord / Q000502:physiology
L'elettrostimolazione spinale nel trattamento delle arteriopatie obliteranti croniche in stadio avanzato.