Spinal cord stimulation in hemodialysis patients with critical lower-limb ischemia

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Uwe BrümmerAmedeo Costantini

Abstract

Spinal cord stimulation (SCS) has been proposed for the treatment of ischemic pain and the prevention or delay of amputation in patients with peripheral arterial occlusive disease (PAOD) who are unsuitable for vascular reconstruction. PAOD is common in patients with end-stage renal disease and is associated with substantial morbidity and mortality. Furthermore, many patients are not candidates for limb-sparing procedures and have to undergo primary amputation. We report our experience with SCS in 8 hemodialysis patients with chronic lower-limb ischemia and not suitable for either primary surgical or angioplastic intervention or reintervention. Intensity of ischemic pain, quality of life, use of analgesic medications, limb survival, and outcome of skin ischemic lesions were evaluated before implantation of an SCS device and after 6 and 12 months of follow-up. No complications from SCS device implantation occurred. Both intensity of pain and quality of life significantly improved during follow-up. SCS allowed a decrease in pain medication intake in all patients. Limb survival at 1 year was 75%. Ischemic skin lesions before implantation of an SCS device did not ameliorate during the follow-up period, but the appearance of new lesi...Continue Reading

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Mar 8, 2007·Neurosurgical Focus·Anthony W Lee, Julie G Pilitsis
Jan 24, 2016·Annals of Vascular Surgery·Giovanni De CaridiAntonio David
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