Spinal cord stimulation for intractable angina

  • J. E. Sanderson
Conference paper

Abstract

Spinal Cord Stimulation has been used in chronic intractable pain syndromes with mixed results. However, in patients with severe peripheral vascular disease it has been shown to lessen pain, hasten the healing of trophic ulcers, and this is associated with an increase in capillary blood flow and transcutaneous oxygen tension (10, 11). It also considerably improves the quality of life (7). It is logical therefore for this technique to be tried in patients with intractable angina which has not responded to the usual treatments of medical therapy, coronary bypass grafting, or balloon angioplasty. In 1987, Murphy and Giles (15) from Australia described 10 patients in which there were significant symptomatic improvement. In 1988, Mannheimer reported on the results in 10 patients again confirming symptomatic improvement and also increased exercise capacity (13). It appeared therefore that this technique was of some potential value in patients with angina, but there have been four major concerns; Firstly, does this therapy merely inhibit the sensation of pain due to ischemia; secondly, could ischemia be increased due to loss of warning; thirdly, will the pain of myocardial infarction be masked; fourthly, could mortality be increased? We have conducted a number of studies in 23 patients with SCS units to try to answer these questions (4, 16, 17, 18, 19, 20).

Keywords

Depression Ischemia Noradrenaline Adrenaline Catecholamine 

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Copyright information

© Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt 1995

Authors and Affiliations

  • J. E. Sanderson
    • 1
  1. 1.Department of Medicine, Prince of Wales HospitalChinese University of Hong KongShatin, N.T.Hong Kong

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