PMID: 9166269May 1, 1997Paper

Discriminative microcirculatory screening of patients with refractory limb ischaemia for dorsal column stimulation

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
P GersbachF Mahler

Abstract

(1) To determine the proportion of patients with critical limb ischaemia refractory to invasive treatment that can be successfully treated by dorsal column stimulation (DCS), and (2) to identify potential responders to DCS by a simple test that is sufficiently predictive to limit the need for a prolonged trial stimulation period. Twenty patients with chronic limb-threatening ischaemia were assessed by a battery of macro- and microcirculatory tests and a DCS trial of 1 week. Favourable response during the trial determined selection for long-term stimulation. During a mean observation period of 14 months, limb salvage rate (LSR) was 63% overall and 83% among patients selected after a favourable trial. Of the tests performed preoperatively, digital subtraction angiography, Doppler assessment, oscillometry, capillaroscopy, foot temperature, and transcutaneous partial pressure of oxygen (tcpO2) in the supine or sitting position did not adequately predict DCS response. The supine-sitting tcpO2 gradient (delta tcpO2) was a good predictor of DCS outcome, with an 88% LSR when delta tcpO2 > 15 Torr, dropping to 12% when delta tcpO2 < or = 15 Torr. DCS is a rewarding therapeutic option in selected patients with critical limb ischaemia. de...Continue Reading

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Citations

Oct 26, 2001·Current Pain and Headache Reports·T R Deer
Jan 1, 1999·Neuromodulation : Journal of the International Neuromodulation Society·L G Claeys
Aug 1, 2000·Neuromodulation : Journal of the International Neuromodulation Society·L G Claeys
Aug 1, 2000·Neuromodulation : Journal of the International Neuromodulation Society·S J HuberJ S Huber
Mar 8, 2007·Neurosurgical Focus·Anthony W Lee, Julie G Pilitsis
May 2, 2006·Journal of Pain and Symptom Management·Dirk Th Ubbink, Hester Vermeulen
Apr 20, 2013·Functional Neurology·Mauricio MandelGerson Chadi
Sep 27, 2003·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·W AmannUNKNOWN European Peripheral Vascular Disease Outcome Study SCS-EPOS
Dec 17, 1998·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·D T Ubbink, M J Jacobs
Mar 2, 2013·The Cochrane Database of Systematic Reviews·Dirk T Ubbink, Hester Vermeulen
Jan 31, 2020·Regional Anesthesia and Pain Medicine·W Michael HootenM Hassan Murad
Jun 7, 2006·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy· Neuhauser Perkmann
Feb 8, 2021·Annals of Vascular Surgery·Kenneth B ChapmanTariq A Yousef

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