Background: Refractory angina is defined as a
chronic condition characterized by the presence of angina due to coronary
insufficiency which cannot be controlled by a combination of medical
therapy, angioplasty and coronary bypass surgery. Prevalence in the United
States is estimated to be between 300,000-900,000. Spinal cord stimulation
for refractory angina pain relief was first described in 1987 but is still
not widely used in North America. We report our experience with this
treatment. Methods: A retrospective review of
patients referred to the St Pauls Hospital neuromodulation program for
consideration of SCS for refractory angina was conducted. Patients underwent
implantation using a either a two stage approach (percutaneous or permanent
lead trial followed by full system implantation) or full system
implantation. Results: Bewtween 2004-2020 36 patients
underwent full system implantation (2 patients failed the trial and were not
implanted). Of the 36 patients undergoing full system implantation, 33 (92%)
experienced significant reduction of angina, increased exercise tolerance
and/or medication reduction and were considered successful implantation.
Most common lead placement location was at C7 T1.
Conclusions: Spinal cord stimulation is an
effective therapy for patients suffering from crippling angina pain despite
medical optimization.
Spinal cord stimulation for lower limb ischemic pain treatment
