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Eur J Vasc Endovasc Surg · Feb 2001
ReviewThe results of spinal cord stimulation in critical limb ischaemia: a review.
- G H Spincemaille, H C de Vet, D T Ubbink, and M J Jacobs.
- Department of Neurosurgery, Academic Hospital, Maastricht, The Netherlands.
- Eur J Vasc Endovasc Surg. 2001 Feb 1; 21 (2): 99-105.
Objectivesto determine which patients with unreconstructible critical limb ischaemia (CLI) might benefit from spinal cord stimulation (SCS).Methodsliterature review.Resultslimb 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 (DeltaTcpO2) was > or =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).Conclusionrandomised 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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