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: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

^*Corresponding author for this work

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

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

Access to Document

10.1053/ejvs.2000.1291

Cite this

@article{79fed662b8c441809da8c8412cbdb2ec,

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.",

keywords = "Critical limb ischaemia, Microcirculation, Spinal cord stimulation, TcpO",

author = "Spincemaille, {G. H.J.J.} and {De Vet}, {H. C.W.} and D. Ubbink and Jacobs, {M. J.H.M.}",

year = "2001",

month = jan,

day = "1",

doi = "10.1053/ejvs.2000.1291",

language = "English",

volume = "21",

pages = "99--105",

journal = "European Journal of Vascular and Endovascular Surgery",

issn = "1078-5884",

publisher = "W.B. Saunders Ltd",

number = "2",

}

TY - JOUR

T1 - The results of spinal cord stimulation in critical limb ischaemia

T2 - A review

AU - Spincemaille, G. H.J.J.

AU - De Vet, H. C.W.

AU - Ubbink, D.

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

PY - 2001/1/1

Y1 - 2001/1/1

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.

KW - Critical limb ischaemia

KW - Microcirculation

KW - Spinal cord stimulation

KW - TcpO

UR - http://www.scopus.com/inward/record.url?scp=0035086292&partnerID=8YFLogxK

U2 - 10.1053/ejvs.2000.1291

DO - 10.1053/ejvs.2000.1291

M3 - Review article

C2 - 11237781

AN - SCOPUS:0035086292

SN - 1078-5884

VL - 21

SP - 99

EP - 105

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

IS - 2

ER -

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

Abstract

Access to Document

Other files and links

Cite this