Highly Effective

Chronic Critical Limb Ischemia by Dr. med. Arndt Dohmen, Dr. med. Stephan Eder, Dr. med. Wulf Euringer, Prof. Dr. med. Thomas Zeller, Prof. Dr. med. Dr. h. c. Friedhelm Beyersdorf in volume 6/2012

Spinal cord stimulation (SCS) was mentioned only in passing in what was otherwise an excellent review article. SCS is a minimally invasive procedure whose effectiveness has been evaluated in a multitude of studies (2), the AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, the Working Group of the Scientific Medical Specialty Societies) has made a strong recommendation in this context (3). According to our own experiences this method has a sustained effect on pain and increases patients’ walking capacity. The effect on the amputation rate is currently the subject of an observational study. The technique should be employed without delay in cases where surgical or endovascular revascularization procedures in stages IIb, III, and IVa according to Fontaine have been exhausted.

DOI: 10.3238/arztebl.2012.0543a

Dr. med. Donatus Cyron

Klinik für Neurochirurgie, Städtisches Klinikum Karlsruhe

Prof. Dr. med. Martin Storck

Klinik für Gefäß- und Thoraxchirurgie, Städtisches Klinikum Karlsruhe

Conflict of interest statement

The authors declare that that no conflict of interest exists.

References

1. Dohmen A, Eder S, Euringer W, Zeller T, Beyersdorf F: Chronic critical limb ischemia. Dtsch Arztebl Int 2012; 109(6): 95–101.

2. Ubbink DT, Vermeulen H: Spinal cord stimulation for non-reconstructable chronic critical leg ischaemia. Cochrane Database Syst Rev 2005; 3: CD004001

3. Tronnier V, Baron R, Birklein F, Eckert S, Harke H, Horstkotte D, Hügler P, Hüppe M, Kniesel B, Maier C, Schütze G, Thoma R, Treede RD, Vadokas V; Arbeitsgruppe zur Erstellung der S3-Leitlinie: Epidurale Rückenmarkstimulation zur Therapie chronischer Schmerzen. Zusammenfassung der S3-Leitlinie. Schmerz 2011; 25: 484–92.