title: Augmentation of arterial blood velocity with electrostimulation in patients with critical limb ischemia unsuitable for revascularization.
abstract: Aim This pilot study aimed to reveal whether combination of electrostimulation with iloprost treatment achieves better results compared to iloprost alone in patients with critical limb ischemia. Material and methods Patients were randomized into Group 1 ( n = 11, mean age: 65.3 ± 4.2 years, received iloprost infusion protocol alone) or Group 2 ( n = 11, mean age: 62.9 ± 6.7, received iloprost infusion plus standardized protocol of peroneal nerve electrostimulation). Electrostimulation was delivered with 1 Hz frequency, 27 mA current, and 200 ms pulse width. Peak blood flow velocities in the anterior and posterior tibialis arteries were measured with duplex ultrasound. Results There was a slight insignificant increase in blood velocity in anterior tibialis artery in Group 1 (from 17.6 ± 13.0 to 18.6 ± 13.1, p = 0.57), whereas the increase in Group 2 was marked (from 23.8 ± 18.3 to 32.2 ± 19.7, p = 0.01). Blood velocity in posterior tibialis artery also increased in both groups, but it was not of statistical significance. No significant difference was found between two groups in regard to final pulse oximetry oxygen saturation levels. Conclusion Electrostimulation of the peroneal nerve caused a substantial increase in anterior tibialis artery blood velocity when used as an adjunct to medical therapy in patients with critical limb ischemia.
authors.affiliation: 1 Department of Cardiovascular Surgery, Derince Education and Research Hospital, Kocaeli, Turkey.
authors.forename: Seyhan
authors.initials: S
authors.lastname: Yilmaz
authors.affiliation: 2 Department of Radiology, Corum Education and Research Hospital, Corum, Turkey.
authors.forename: Esra U
authors.initials: EU
authors.lastname: Mermi
authors.affiliation: 3 Department of General Surgery, Corum Education and Research Hospital, Corum, Turkey.
authors.forename: Ethem
authors.initials: E
authors.lastname: Zobaci
authors.affiliation: 4 Department of Cardiovascular Surgery, American Hospital, Istanbul, Turkey.
authors.forename: Eray
authors.initials: E
authors.lastname: Aksoy
authors.affiliation: 3 Department of General Surgery, Corum Education and Research Hospital, Corum, Turkey.
authors.forename: Çınar
authors.initials: Ç
authors.lastname: Yastı
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D016285:Iloprost / Q000009:adverse effects / Q000627:therapeutic use*; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D010543:Peroneal Nerve; D010865:Pilot Projects; D011446:Prospective Studies; D012039:Regional Blood Flow; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D016285:Iloprost
keywords: Critical limb ischemia; electrostimulation; iloprost; peripheral artery disease