International angiology : a journal of the International Union of Angiology
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Randomized Controlled Trial Clinical Trial
Transcutaneous oxygen pressure as predictive parameter for ulcer healing in endstage vascular patients treated with spinal cord stimulation.
This study was designed to test the hypothesis that initial TcPO2 helps predict clinical outcome in vascular patients treated with spinal cord stimulation. A randomized-controlled study with one year follow-up was made in 86 Fontaine stage IV patients with endstage peripheral arterial occlusive disease (PAOD) undergoing 21 day intravenous prostaglandin E1 (PGE1) therapy for nonhealing ulcers. ⋯ Spinal cord stimulation appears to provide a major benefit for lesion improvement in stage IV patients with non-reconstructible PAOD. Patients with an initial TcPO2 > 10 mmHg will respond better to the stimulation therapy. With pain relief and ulcer healing quality of life improved. Effects on limb salvage do not appear.
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Duplex ultrasonography has gained enormous importance in the vascular practice over the last decade. Technological development with the colour application as well as the high resolution imaging have altered the diagnostic approach, treatment and follow-up of the vascular patients. ⋯ This article presents an overview of the revolutionary role of the ultrasonic investigations in the arterial and venous disease and outlines the possible limitations of the technique. Financial aspects of its use in the health care system and potential advents in the near future are also discussed.