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Cucuruz B, Kopp R, Hampe-Hecht H, Andercou O, Schierling W, Pfister K, Koller M, Noppeney T. Treatment of end-stage peripheral artery disease by Neuromodulation. Clin Hemorheol Microcirc 2022; 81:315-324. [DOI: 10.3233/ch-221436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND: Neuromodulation is a therapeutic option to improve limb salvage in end-stage peripheral arterial disease (PAD), but there is no consensus on indication for spinal cord stimulation (SCS) in PAD patients. OBJECTIVE: The aim of this study was to present end-stage PAD patient outcomes treated with SCS. METHODS: This study is a retrospective analysis based on a local prospective registry. Neuromodulation was performed there was: [1] no revascularisation option, [2) no septicaemia, [3) Rutherford stage 4–6. The primary endpoint of the study was limb salvage. Secondary endpoints were improvement in pain symptoms (assessed using a visual anlog scale/VAS) and improvement in walking distance. RESULTS: Limb salvage was reached in 30/34 patients (88%). Patients reported a significant reduction in pain on the 10-point VAS scale from baseline (median = 7.5, IQR = 7–8) to follow-up at 2 years (median = 0, IQR 0–2.75), p < 0.001. Walking distance also improved from preoperative (median = 50 m, IQR = 20–50 m) to follow-up at 2 years (median = 150 m, IQR 50–272 m), p < 0.001. RESULTS: SCS implantation in patients with end-stage PAD can enable limb salvage in a high percentage of cases and increase mobility due to pain reduction. The role of microcirculation in these improvements needs to be investigated in further studies.
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Affiliation(s)
- B. Cucuruz
- University Hospital Halle, Department of Radiology, Halle, Germany
- Martha Maria Hospital Nuremberg, Department of Vascular Surgery, Nuremberg, Germany
- University Hospital Regensburg, Department of Vascular Surgery, Regensburg, Germany
| | - R. Kopp
- University Hospital Zürich, Department of Vascular Surgery, Zürich, Switzerland
| | - H. Hampe-Hecht
- Martha Maria Hospital Nuremberg, Department of Vascular Surgery, Nuremberg, Germany
| | - O. Andercou
- University Hospital Cluj, Department of Surgery, Cluj, Romania
| | - W. Schierling
- University Hospital Regensburg, Department of Vascular Surgery, Regensburg, Germany
| | - K. Pfister
- University Hospital Regensburg, Department of Vascular Surgery, Regensburg, Germany
| | - M. Koller
- University Hospital Regensburg, Center for Clinical Studies, Regensburg, Germany
| | - T. Noppeney
- Martha Maria Hospital Nuremberg, Department of Vascular Surgery, Nuremberg, Germany
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