The results of spinal cord stimulation in critical limb ischaemia: A review

G. H.J.J. Spincemaille; H. C.W. De Vet; D. Ubbink; M. J.H.M. Jacobs

doi:https://doi.org/10.1053/ejvs.2000.1291

The results of spinal cord stimulation in critical limb ischaemia: A review

G. H.J.J. Spincemaille, H. C.W. De Vet, D. Ubbink, M. J.H.M. Jacobs

Research output: Contribution to journal › Review article › Academic › peer-review

37 Citations (Scopus)

Abstract

Objectives: to determine which patients with unreconstructible critical limb ischaemia (CLI) might benefit from spinal cord stimulation (SCS). Methods: literature review. Results: limb salvage in patients with an intermediate transcutaneous oxygen pressure (TcpO₂) was not significantly higher with SCS (76%) than with conservative therapy (p = 0.08). However, a limb salvage of 88% was achieved with SCS if the difference between the supine and sitting TcpO₂ baseline values (ΔTcpO₂) was ≥ 15 mmHg. A rise in TcpO₂ after trial stimulation of at least 15% resulted in a limb salvage of 77% at 18 months (p<0.01). Conclusion: randomised studies show no benefit of SCS over conservative therapy in patients with non-reconstructible CLI. However, data from experimental and non-randomised studies suggest this may be due to sub-optimal patient selection for SCS. Further trials are needed to identify subgroups who may benefit from SCS.

Original language	English
Pages (from-to)	99-105
Number of pages	7
Journal	European Journal of Vascular and Endovascular Surgery
Volume	21
Issue number	2
DOIs	https://doi.org/10.1053/ejvs.2000.1291
Publication status	Published - 1 Jan 2001

Keywords

Critical limb ischaemia
Microcirculation
Spinal cord stimulation
TcpO

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title = "The results of spinal cord stimulation in critical limb ischaemia: A review",

abstract = "Objectives: to determine which patients with unreconstructible critical limb ischaemia (CLI) might benefit from spinal cord stimulation (SCS). Methods: literature review. Results: limb salvage in patients with an intermediate transcutaneous oxygen pressure (TcpO2) was not significantly higher with SCS (76%) than with conservative therapy (p = 0.08). However, a limb salvage of 88% was achieved with SCS if the difference between the supine and sitting TcpO2 baseline values (ΔTcpO2) was ≥ 15 mmHg. A rise in TcpO2 after trial stimulation of at least 15% resulted in a limb salvage of 77% at 18 months (p<0.01). Conclusion: randomised studies show no benefit of SCS over conservative therapy in patients with non-reconstructible CLI. However, data from experimental and non-randomised studies suggest this may be due to sub-optimal patient selection for SCS. Further trials are needed to identify subgroups who may benefit from SCS.",

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AU - Ubbink, D.

AU - Jacobs, M. J.H.M.

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N2 - Objectives: to determine which patients with unreconstructible critical limb ischaemia (CLI) might benefit from spinal cord stimulation (SCS). Methods: literature review. Results: limb salvage in patients with an intermediate transcutaneous oxygen pressure (TcpO2) was not significantly higher with SCS (76%) than with conservative therapy (p = 0.08). However, a limb salvage of 88% was achieved with SCS if the difference between the supine and sitting TcpO2 baseline values (ΔTcpO2) was ≥ 15 mmHg. A rise in TcpO2 after trial stimulation of at least 15% resulted in a limb salvage of 77% at 18 months (p<0.01). Conclusion: randomised studies show no benefit of SCS over conservative therapy in patients with non-reconstructible CLI. However, data from experimental and non-randomised studies suggest this may be due to sub-optimal patient selection for SCS. Further trials are needed to identify subgroups who may benefit from SCS.

AB - Objectives: to determine which patients with unreconstructible critical limb ischaemia (CLI) might benefit from spinal cord stimulation (SCS). Methods: literature review. Results: limb salvage in patients with an intermediate transcutaneous oxygen pressure (TcpO2) was not significantly higher with SCS (76%) than with conservative therapy (p = 0.08). However, a limb salvage of 88% was achieved with SCS if the difference between the supine and sitting TcpO2 baseline values (ΔTcpO2) was ≥ 15 mmHg. A rise in TcpO2 after trial stimulation of at least 15% resulted in a limb salvage of 77% at 18 months (p<0.01). Conclusion: randomised studies show no benefit of SCS over conservative therapy in patients with non-reconstructible CLI. However, data from experimental and non-randomised studies suggest this may be due to sub-optimal patient selection for SCS. Further trials are needed to identify subgroups who may benefit from SCS.

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KW - Microcirculation

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The results of spinal cord stimulation in critical limb ischaemia: A review

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Keywords

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