The feasibility of skin perfusion pressure to evaluate the efficacy of spinal cord stimulation for critical limb ischemia due to Buerger's disease

Abstract

One of the major complications affecting the activity of daily living (ADL) in the patients with Buerger's disease is the amputation of the extremities due to serious ischemia and resultant necrosis. There are many patients with Buerger's disease who are resistant to such treatments as pharmacological interventions, lumbar sympathetic ganglion block, and surgical revascularization. We have introduced spinal cord stimulation (SCS) treatment in a patient with Buerger's disease, resistant to those treatments. The effect of SCS was evaluated using the skin perfusion pressure (SPP). SPP was less than 30 mmHg prior to SCS, and defined as critical limb ischemia (CLI), but increased to greater than 40 mmHg 3 months after SCS with better ADL. For the patients with CLI, it is possible that SCS might improve peripheral perfusion, thus improve CLI, which can be monitored by SPP.