Artikel
The value of spinal cord stimulation in chronic intractable angina pectoris
Die Bedeutung der Rückenmarkstimulation bei der refraktären Angina pectoris
Suche in Medline nach
Autoren
Veröffentlicht: | 4. Mai 2005 |
---|
Gliederung
Text
Objective
In Europe, an annual incidence rate of 30.000 to 50.000 cases of chronic intractable angina pectoris (AP) is reported. An effective interventionel therapy or operative revascularisation is often impossible. The chronic disease lowers quality of life significantly and is accompanied by a increased psychic co-morbidity. Spinal cord stimulation (SCS) is an effective and save therapeutical option for these patients.
Methods
Within 32 months 26 patients where classified as chronic intractable AP-patients after non-invasive diagnostic procedures. In all of them we implanted a SCS-system (Itrel3®, Medtronic). Patients were examined preoperatively as well as 3,6 and 12 weeks after implantation. The investigations included cardiac functional efficiency (bicycle ergometer, 6 minutes walking range), quality of life (VAS 0-100, Seattle Angina Questionnaire SAQ 0-100) as well as frequency of angina attacks and intake of nitrate (CCS – Classification).
Results
After 3 month of SCS all patients experienced a significant improvement in their symptoms and quality of life. Frequency of angina attacks had decreased from 8,6 preoperatively per day to 2,0 and the intake of nitrate was reduced. The severity of angina attacks had decreased from 3,6 to 1,5 (CCS). The Seattle Angina Questionnaire (SAQ) was improved reflecting a better quality of life. VAS ameliorated from 33 to70. in the 6 minute walking range test the symptom-free distance prolonged from 271 to 423 meters.
Conclusions
Spinal cord stimulation is a safe and effective method in treatment in intractable angina pectoris improving not only the symptoms of severe angina, but also the quality of life. According to our results SCS appears to be a good minimal invasive and low risk method for patients who have no other therapeutical options.