Peripheral Neuromodulation for Angina: Gathering Momentum

Permanent Percutaneous Splanchnic Nerve Neuromodulation for Management of Pain due to Chronic Pancreatitis: A Case Report

“…As the final position of the leads was in the proximity of greater and lesser splanchnic nerves and the celiac plexus, we carried out stimulation at various frequencies and the most preferred frequencies were 2–10 Hz. This is in keeping with our experience with lumbar sympathetic chain stimulation where a series of patients preferred low‐frequency stimulation (13–16). Shimoji et al.…”

“…The prolonged effect of stimulation with monoelectrode catheters has been in line with our previous observations of successful applications of this modality in neuropathic pain assessment and treatment (13–16). The trial lasted for one week with complete pain relief (VAS 0/10).…”

“…She was using the stimulator for up to six hours a day in total and specifically for 20 min before meals. The relatively short duration of stimulation (6/24) to achieve desirable pain control has been reported previously in patients with various forms of low‐frequency peripheral stimulation (13–16). The stimulation parameters were a frequency of 2 Hz, pulse width 450 µsec, and amplitude from 2–3.5 volts.…”

“…She chose not to undergo major surgery. We decided in favor of splanchnic nerve/celiac plexus neuromodulation based on our successful experience with lumbar sympathetic chain neuromodulation for loin pain hematuria syndrome (13–15). One and a half years postprocedure the patient continues to benefit from the stimulation with no device related complications and a reduction of analgesic medications.…”

“…A Whipple's procedure was suggested as a last resort, but the patient chose not to undergo the procedure. After discussing her case in a multidisciplinary meeting, we decided to carry out celiac plexus neuromodulation, as our previous experience from catheter trial stimulation of celiac plexus for pain of chronic pancreatitis (13,14) and lumbar sympathetic chain neuromodulation in controlling pain from loin pain hematuria syndrome (15) were very successful. In the report on loin hematuria syndrome the stimulation was clearly targeted at the lower part of the sympathetic chain in the lumbar region with the aim of capturing the renal sympathetic supply.…”