Die epidurale Rückenmarkstimulation (SCS) zur Therapie peripherer arterieller Durchblutungsstörungen [Spinal cord stimulation (SCS) in the treatment of peripheral arterial occlusive disease]

Spinal cord stimulation (SCS) represents a well established procedure in the treatment of critical ischemia of the extremities. The knowledge and distribution of SCS in Austria are still poor despite satisfactory data. The evaluations and recommendations from the consensus group demonstrate that SCS might represent a suitable additional treatment option for selected patients with peripheral arterial disease (PAD) when performed in experienced centers under clear indications. The complication rate is low and mainly due to device-related problems. There are valid scientific criteria proving that SCS treatment can reduce the risk of amputation, decrease pain and improve wound healing in patients with non-reconstructable, non-unstable PAD in stages IV and V according to Rutherford (stages III and IV according to Fontaine).This effect is more evident when patient selection is based on tcPO(2) measurements. A careful selection of patients is essential for the success of this neuromodulatory treatment, in addition a certain degree of patient compliance in terms of perception and understanding of the therapy is mandatory.