The best TcpO(2) parameters to predict the efficacy of spinal cord stimulation to improve limb salvage in patients with inoperable critical leg ischemia

Details

Serval ID
serval:BIB_F0661096BF45
Type
Article: article from journal or magazin.
Collection
Publications
Title
The best TcpO(2) parameters to predict the efficacy of spinal cord stimulation to improve limb salvage in patients with inoperable critical leg ischemia
Journal
International Angiology
Author(s)
Ubbink  D. T., Gersbach  P. A., Berg  P., Amann  W., Gamain  J.
ISSN
0392-9590 (Print)
Publication state
Published
Issued date
12/2003
Volume
22
Number
4
Pages
356-63
Notes
Journal Article --- Old month value: Dec
Abstract
AIM: Spinal cord stimulation (SCS) is available as an alternative therapy for patients suffering from inoperable critical limb ischemia (CLI). Selection of patients is essential to achieve the best treatment effect. For this purpose transcutaneous oxygen (TcpO(2)) measurements have frequently been applied. So far, it is unclear which TcpO(2) parameters serve this purpose best. METHODS: Studies in which inoperable CLI patients were treated with conservative treatment with or without SCS, and in whom various TcpO(2) measurements were performed before and during treatment were pooled to investigate which TcpO(2) parameter(s) were best to detect patients who benefit most from SCS treatment as to limb salvage. RESULTS: TcpO(2) in the supine position increased significantly (p<0.001) in patients after a short period of SCS treatment (from 9 to 22 mmHg), but not in those treated conservatively (from 7 to 7 mmHg). Baseline supine TcpO(2) (using a cut-off value of 10 mmHg), the baseline sitting-supine TcpO(2) difference (cut-off value: 17 mmHg), and the difference in TcpO(2) before and after test stimulation (cut-off value: 4 mmHg) were related to a significantly increased limb salvage. SCS patients with a sitting-supine TcpO(2) difference of >17 mmHg had a 1-year limb salvage of 83% vs 68% in the whole SCS-treated group irrespective of TcpO(2) selection. CONCLUSION: The TcpO(2) parameters mentioned above are capable of detecting the effect of SCS treatment. Selection using (a combination of) TcpO(2) measurements substantially improves limb salvage of patients treated with SCS for inoperable CLI.
Keywords
Aged *Blood Gas Monitoring, Transcutaneous Critical Illness *Electric Stimulation Therapy Female Follow-Up Studies Humans Ischemia/*therapy Leg/*blood supply *Limb Salvage Male Predictive Value of Tests *Spinal Cord
Pubmed
Web of science
Create date
28/01/2008 10:17
Last modification date
03/03/2018 22:36
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