Spinal Cord Stimulation in Hemodialysis Patients With Critical Lower-Limb Ischemia

Brümmer, Uwe; Condini, Viviana; Cappelli, P; Liberato, Lorenzo Di; Scesi, M; Bonomini, Mario; Costantini, A

doi:10.1053/j.ajkd.2006.02.172

Cited by 19 publications

(18 citation statements)

References 18 publications

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“…Complications from SCS include lead migration, lead connection failure, lead break, local pain, wound seroma, haematoma and infection. Hardware‐related complications are the most common and can occur in 11–36% of patients, with infection being the next most common, occurring in 3–6·3% of patients .…”

Section: Introductionmentioning

confidence: 99%

Spinal cord stimulation to achieve wound healing in a primary lower limb critical ischaemia referral centre

Caridi

Massara

David

et al. 2014

International Wound Journal

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Critical lower limb ischaemia is a diffuse pathology that could cause claudication, severe ischaemic pain and tissue loss. The common treatment includes modification of risk factors, pharmacological therapy and endovascular or surgical revascularisation of the lower limb to restore a pulsatile flow distally. Spinal cord stimulator is seen as a valid alternative in patients unsuitable for revascularisation after endovascular or surgical revascularisation failure and as adjuvant therapy in the presence of a functioning bypass in patients with extensive tissue loss and gangrene presenting a slow and difficult wound healing. We report our experience on spinal cord stimulation (SCS) indication and implantation in patients with critical lower limb ischaemia, at a high-volume centre for the treatment of peripheral arterial disease.

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Section: Introductionmentioning

confidence: 99%

Spinal cord stimulation to achieve wound healing in a primary lower limb critical ischaemia referral centre

Caridi

Massara

David

et al. 2014

International Wound Journal

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“…Limb survival was reported at 75%. 8 Though a small study, it highlights the opportunity of this therapy in a patient population that has been considered at a disadvantage for revascularization and limb salvage procedures.…”

Section: Scs and Pvdmentioning

confidence: 99%

“…These effects lead to a decrease in vascular resistance and an increase in local blood flow ( Figure 1). 7,8,15,16 In addition, SCS suppresses sympathetic vasoconstriction through inhibition of sympathetic nicotine transmission at the ganglionar and postganglionar level. 3,4,7 Pain relief is mediated by the suppression of pain or nociceptive transmission and the release of opioid peptides such as met-enkephalin.…”

Section: Mechanism Of Action In Pvdmentioning

confidence: 99%

“…Hardware-related complications are the most common and can occur in 11-36% of patients, with infection being the next most common, occurring in 3-6.3% of patients. 8,9,10,12 …”

mentioning

confidence: 99%

“…3,8 Briefly, spinal cord stimulation requires the insertion of electrodes into the epidural space, with the electrodes connected to an impulse generator. 9 To treat lower-extremity pain in patients with CLI, 4 to 8 electrodes are generally placed in the epidural space between the thoracic 8 and 11 level through a paralaminar level 1 or 2 lumbar puncture.…”

mentioning

confidence: 99%

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Spinal Cord Stimulation for Chronic Limb Ischemia

Naoum

Arbid

2013

Methodist DeBakey Cardiovascular Journal

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The treatment of chronic limb ischemia involves the restoration of pulsatile blood flow to the distal extremity. Some patients cannot be treated with endovascular means or with open surgery; some may have medical comorbidities that render them unfit for surgery, while others may have persistent ischemia or pain even in the face of previous attempts at reperfusion. In spinal cord stimulation (SCS), a device with electrodes is implanted in the epidural space to stimulate sensory fibers. This activates cell-signaling molecules that in turn cause the release of vasodilatory molecules, a decrease in vascular resistance, and relaxation of smooth muscle cells. SCS also suppresses sympathetic vasoconstriction and pain transmission. When patient selection is based on microcirculatory parameters, SCS therapy can significantly improve pain relief, halt the progression of ulcers, and potentially achieve limb salvage.

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