Subcutaneous Targeted Stimulation

Peripheral Neuromodulation for Angina: Gathering Momentum

“…Dear Sir, We read with great interest Dr Buiten and colleagues' report, together with the reviewer's comments on the application of peripheral subcutaneous stimulation for the treatment of refractory angina (1). It is extremely satisfying for us that the results of this study have fully supported our previous initial investigations, observations, and studies (2)(3)(4)(5)(6)(7). It is worth noting that in two of our reported patients, SCS wasn't very effective, contrary to excellent angina control by peripheral stimulation.…”

To Test or Not to Test in Peripheral Nerve Stimulation?

“…There are other simpler and more precise techniques that can be used to this effect. For instance, a regional-anesthesia-based approach to locate the affected nerve with a single needle and a nerve stimulator would allow us to elicit precise paresthesia (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Even this technique might have some limitations.…”

“…Since the authors are striving to reduce the number of patients implanted in vain, we are perplexed by their decision not to include intraoperative testing in their peripheral neuromodulation implant technique. From personal experience, we believe that on-table testing is particularly important for peripheral nerve stimulation (3)(4)(5)(6)(7)(8)(9)(10)(11)(12); this can be complemented by ultrasound-guided placement of leads (13)(14)(15) to achieve optimal position of the stimulating lead. For peripheral neuromodulation in general, incorrect placement of leads may result in inadequate pain relief due to poor coverage, or even in painful and unwanted stimulation (16,17).…”

The Effect of Peripheral Neuromodulation on Pain From the Sacroiliac Joint: A Retrospective Cohort Study

“…The introduction of new peripheral neuromodulation techniques such as peripheral nerve field stimulation (PNFS), where stimulation is directed at the site (center) of pain (17), has created an impetus for the expansion of PNFS to new indications (18)(19)(20)(21)(22)(23)(24)(25)(26)(27). However, terminology of this modality is still far from being fully established (28,29).…”