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Laser Doppler Flowmetry and Transcutaneous Oxygen Tension in Patients with Severe Arterial Insufficiency Treated by Epidural Spinal Cord Electrical Stimulation

Department of Surgery, University of Rome "La Sapienza,"

Andrea Mingoli

Department of Surgery, University of Rome "La Sapienza,"

Claudia Maggiore

Department of Surgery, University of Rome "La Sapienza,"

Dario Fiume

Department of Neurosurgery, San Filippo Neri Hospital, Rome, Italy

Luca di Marzo

Department of Surgery, University of Rome "La Sapienza,"

Marco Tamorri

Department of Neurosurgery, San Filippo Neri Hospital, Rome, Italy

Antonino Cavallaro

Department of Surgery, University of Rome "La Sapienza,"

Six patients (3 men, 3 women, mean age 74.2 years) affected by severe arterial insufficiency with rest pain and/or necrosis (smaller than 3 cm2) have been studied simultaneously by means of transcutaneous oxygen tension (Tcp02) and laser Doppler flowmetry (LDF) measurements.

They had been submitted to epidural spinal cord electrical stimulation (ESES) device implant from one week to thirteen months previously.

Tcp0₂ vasodilation index and LDF flow and LDF volume increased in 5 patients in whom the ESES was effective in pain relief and ulcer healing. In 1 diabetic patient the clinical result was poor and neither Tcp0₂ nor LDF showed any improvement.

The LDF flow and LDF volume increase, coupled with the simultaneous Tcp0₂ vasodilation index increase, testify to the amelioration of the cutaneous microcir culation, related to a diminished vasomotor tone (sympathetic activity), induced by ESES .

In diabetic patients with neuropathy (autonomic sympathectomy) a high vasodilation index contraindicates ESES implant.

Vascular and Endovascular Surgery, Vol. 25, No. 3, 165-170 (1991)
DOI: 10.1177/153857449102500301


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