Stimolazione elettrica epidurale e qualità della vita nei pazienti affetti da angina pectoris refrattaria.

Translated title of the contribution: Spinal cord stimulation and quality of life in patients with refractory angina

D. Rapati, R. Capucci, M. Berti, G. Danelli, G. Torri, O. Alfieri

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Spinal cord stimulation (SCS) is a treatment that exploits the antalgic and vasodilatory effects on the microcirculation produced by a stimulating electrode positioned in the peridural space. This therapy has been used for years in the treatment of refractory angina pectoris. The aim of this study was to monitor the clinical effectiveness of the technique in terms of symptomatic benefits and, above all, improved quality of life in angina patients undergoing SCS. METHODS: From November 1998 to December 2000 we used SCS to treat 17 patients with refractory angina (functional class III or IV Canadian Cardiovascular Society) with onset more than one year earlier. All patients had undergone one or more traditional revascularisation procedures and were receiving maximum drug therapy. Patients were assigned to SCS because it was not technically possible to perform other revascularisation procedures. Quality of life was measured before and after treatment using a multidimensional index (QL Spitzer's index). We also noted the mortality, acceptance and morbidity of the procedure during a follow-up lasting 10 months on average. Lastly, the number of weekly anginal pain attacks, weekly nitrate consumption and CCS functional class were recorded before treatment and 1, 3 and six months after therapy. RESULTS: SPC was effective in 13 patients out of 17 (76.47%). In responders the quality of life improved by 70%: in these patients, the number of weekly angina attacks reduced from 11.76+/-7.56 to 2.14+/-2.54, and the functional class from 3.30+/-0.75 to 1.5+/-0.53. No major periprocedural complications were reported. The annual mortality rate was 6.6%. The technique was easy to use. CONCLUSIONS: The results of this study show that SCS is effective, safe, easy to use and well tolerated by patients with refractory angina who fail to respond to traditional revascularisation. This technique substantially improves the quality of life of patients suffering from refractory angina.

Original languageItalian
Pages (from-to)803-810
Number of pages8
JournalMinerva Anestesiologica
Volume67
Issue number11
Publication statusPublished - Nov 2001

Fingerprint

Spinal Cord Stimulation
Quality of Life
Therapeutics
Mortality
Angina Pectoris
Microcirculation
Nitrates
Electrodes
Morbidity
Drug Therapy
Pain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Stimolazione elettrica epidurale e qualità della vita nei pazienti affetti da angina pectoris refrattaria. / Rapati, D.; Capucci, R.; Berti, M.; Danelli, G.; Torri, G.; Alfieri, O.

In: Minerva Anestesiologica, Vol. 67, No. 11, 11.2001, p. 803-810.

Research output: Contribution to journalArticle

Rapati, D. ; Capucci, R. ; Berti, M. ; Danelli, G. ; Torri, G. ; Alfieri, O. / Stimolazione elettrica epidurale e qualità della vita nei pazienti affetti da angina pectoris refrattaria. In: Minerva Anestesiologica. 2001 ; Vol. 67, No. 11. pp. 803-810.
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abstract = "BACKGROUND: Spinal cord stimulation (SCS) is a treatment that exploits the antalgic and vasodilatory effects on the microcirculation produced by a stimulating electrode positioned in the peridural space. This therapy has been used for years in the treatment of refractory angina pectoris. The aim of this study was to monitor the clinical effectiveness of the technique in terms of symptomatic benefits and, above all, improved quality of life in angina patients undergoing SCS. METHODS: From November 1998 to December 2000 we used SCS to treat 17 patients with refractory angina (functional class III or IV Canadian Cardiovascular Society) with onset more than one year earlier. All patients had undergone one or more traditional revascularisation procedures and were receiving maximum drug therapy. Patients were assigned to SCS because it was not technically possible to perform other revascularisation procedures. Quality of life was measured before and after treatment using a multidimensional index (QL Spitzer's index). We also noted the mortality, acceptance and morbidity of the procedure during a follow-up lasting 10 months on average. Lastly, the number of weekly anginal pain attacks, weekly nitrate consumption and CCS functional class were recorded before treatment and 1, 3 and six months after therapy. RESULTS: SPC was effective in 13 patients out of 17 (76.47{\%}). In responders the quality of life improved by 70{\%}: in these patients, the number of weekly angina attacks reduced from 11.76+/-7.56 to 2.14+/-2.54, and the functional class from 3.30+/-0.75 to 1.5+/-0.53. No major periprocedural complications were reported. The annual mortality rate was 6.6{\%}. The technique was easy to use. CONCLUSIONS: The results of this study show that SCS is effective, safe, easy to use and well tolerated by patients with refractory angina who fail to respond to traditional revascularisation. This technique substantially improves the quality of life of patients suffering from refractory angina.",
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