Front. Surg.

Sec. Vascular Surgery

Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1451622

This article is part of the Research Topic Diagnosis and Treatment for Arteriosclerosis and Thrombosis View all 3 articles

Provisionally accepted

Anna Ewa Cyrek 1,2* Dietrich Koch 2 Arkadius Pacha 3 Sonia Radunz 2 1 Essen University Hospital, Essen, Germany 2 Department of General, Visceral and Tranplantation Surgery, Essen University Hospital, Essen, North Rhine-Westphalia, Germany 3 Institute for Pharmacology and Toxicology, Faculty of Medicine, Ruhr University Bochum, Bochum, North Rhine-Westphalia, Germany

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Background: Chronic limb-threatening ischemia (CLTI) is the most severe form of peripheral artery disease (PAD). Patients with diabetes mellitus (DM) have a faster progression of PAD and a fourfold increased risk of CLTI compared to patients without DM. Epidural spinal cord stimulation (SCS) has been used as a method to improve microcirculation, relieve ischemic pain and reduce the number of amputations in patients with PAD. This is a retrospective subgroup small cohort analysis of patients with diabetes and the long-term treatment effect of spinal cord stimulation.Methods: As the main outcome of the study, we evaluated the survival and amputation of 13 diabetic patients with chronic lower-limb ischemia who were not eligible for surgical or interventional therapy. Secondary outcomes included ankle-brachial index (ABI), ischemic pain intensity, quality of life, use of analgesic medications and skin wound outcomes analyzed during long-term follow-up.Results: Between January 2010 and January 2017, 13 patients underwent SCS implantation in our vascular center. At 1-year follow-up, the limb salvage rate was 92.3% (12 of 13 patients), and limb ulcers healed in 75% of patients (6/8). No patient died during the one-year follow-up. A total of 4 of patients (31%) experienced major amputation during long-term follow-up, all of them were Fontaine stage IV. Pain intensity and quality of life improved significantly at 6-month follow-up (p

Keywords: Critical limb-threatening ischemia, Peripheral Arterial Disease, Neuromodulation, long-term results, Limb Salvage, Quality of Life, Diabetic patients

Received: 19 Jun 2024; Accepted: 25 Nov 2024.

Copyright: © 2024 Cyrek, Koch, Pacha and Radunz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Anna Ewa Cyrek, Essen University Hospital, Essen, Germany

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