gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Increased myocardial blood flow after spinal cord stimulation in patients with refractory angina pectoris

Erhöhter Myokardialer Blutfluss nach Rückenmarks-Stimulation bei Patienten mit resistenter Angina Pectoris

Meeting Abstract

  • corresponding author A. Koulousakis - Department of Stereotaxy, Universitätskliniken Köln
  • H. Dietrichs - Department of Cardiology, Universitätskliniken Köln
  • E. Voth - Department of Nuclear Medicine, Universitätskliniken Köln
  • M. Weber - Department of Stereotaxy, Universitätskliniken Köln
  • C. Zobel - Department of Cardiology, Universitätskliniken Köln
  • R. Schwinger - Department of Cardiology, Universitätskliniken Köln

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP044

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0312.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Koulousakis et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background

In spite of great progresses in surgical and catheter interventional techniques, there is an increasing number of patients with coronary heart disease not suitable for these conventional treatment strategies. A number of patients suffer from intractable pain, in spite of appropriate medication.

Therapy

A recent review of the Study Group on the treatment of refractory angina pectoris of the European Society of Cardiology (ESC) recommends spinal cord stimulation (SCS) as first-line therapy. SCS is a well-known and often used therapy for refractory angina in other European countries, but not in Germany.

Results

The present study in 30 patients shows that SCS is an efficient therapy. The quadropolar electrode was placed at the level TH1-left paramedian and after a trial period, it was connected to a programmable pulse generator. By reduction of angina symptoms and a consecutive increase of exercise capacity, the patients experience a great improvement in quality of life. In addition, recent data of our own study suggest a significant decrease in myocardial ischemia - examined by MIBI-SPECT - in patients under SCS. This might be a direct effect of SCS, perhaps due to sympaticolysis or due to a better collateralization because of the improved exercise capacity.

Conclusion

In agreement with the study group of the ESC, we would recommend SCS as first-line therapy for refractory angina pectoris. As a matter of course, conventional treatment strategies should not be replaced by SCS. Hence, a strict evaluation before implanting a SCS device is indispensible.