Engelsk titel: Epidural spinal cord stimulation in chronic refractory angina pectoris
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Författare:
Myran R
;
Jörgensen JV
;
Wiseth R
Email: rigmor.myran@medisin.ntnu.no
Språk: Nor
Antal referenser: 14
Dokumenttyp:
Artikel
UI-nummer: 04111510
Sammanfattning
BACKGROUND : Chronic refractory angina pectoris is defined as a condition with coronary insufficiency that cannot be controlled by a combination of medical therapy, angioplasty or bypass surgery. Different treatment options are evaluated in this patient group; spinal cord stimulation (SCS) is the one that is best documented. We have used this method since 1996 and present our experience.
MATERIALS AND METHODS : From 1996 to 2001, spinal cord stimulators were implanted in 21 patients. A follow-up study was performed after 27 months (range 7-71) with a questionnaire. Preoperative clinical and angiographic data were retrieved from our records.
RESULTS : 17 men and 4 women aged 55-88 years (median 73) were treated with SCS. Preoperatively all patients were in CCS (Canadian Cardiovascular Society) class III-IV. 81% had previously undergone coronary artery bypass surgery. At follow up, 81% were alive. Lead fracture occurred in two patients, displacement of the electrode in one. There were no other complications. 71% reported symptomatic improvement, mean CCS class was reduced from 3.5 prior to SCS to 2.2 at follow up, and use of nitroglycerin was reduced.
INTERPRETATION : In chronic refractory angina pectoris, spinal cord stimulation is an alternative. We report "beginners' experience" that is positive including substantial symptomatic effect and a low complication rate. More hospitals in Norway should consider establishing SCS in order to offer this treatment option to a growing patient group.