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Improvement of Microcirculatory Blood Flow underEpidural Spinal Cord Stimulation in Patients withNonreconstructible Peripheral Arterial Occlusive Disease


  • Luc Georges Y. Claeys

    1. Department of Vascular Surgery, General Hospital Cologne-Porz, Cologne Medical School, Academic Teaching Hospitalof the University of Cologne, Cologne, Germany
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Dr. Luc G.Y. Claeys University of Vienna, Wăhringer Gürtel 18–20, A-1090Vienna, Austria.


Epidural spinal cord stimulation (ESCS) hasbeen suggested as a method to improve microcirculatoryblood flow and to reduce the amputation rate in vascularpatients. We studied the effects of ESCS onmicrocirculatory blood flow in 237 patients with nonreconstructibleperipheral arterial occlusive disease. Clinical status wasclassified as Fontaine Stage 3 (ischemic rest pain) in 169patients and as Fontaine Stage 4 (ulcers/gangrene) in 68patients. After a mean follow-up period of 31.2 months,major pain relief (>75%) was noticed in patients whoretained their limbs. Sixty-four patients underwent majoramputation despite ESCS. Clinical improvement wasconfirmed by the increase in transcutaneous oxygen(TcPo2).