Peripheral Nerve Stimulation in Nonreconstructable Critical Limb-Threatening Ischemia: A Case Series

Patients with chronic limb-threatening ischemia (CLTI) who are not candidates for further revascularization frequently endure intractable pain, with major amputation often being the only remaining therapeutic option. We report 10 patients with severe peripheral arterial disease and nonreconstructable CLTI who underwent ultrasound-guided peripheral nerve stimulation (PNS) of the femoral and sciatic nerves for analgesia and possible limb preservation. Two avoided major amputation; eight underwent amputation a median of 33 days after implantation (interquartile range, 10-57.8). These preliminary findings suggest that PNS may provide pain relief and temporary prolongation of limb preservation in patients with advanced CLTI without revascularization options.