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THE SIBERIAN EXPERIENCE OF SPINAL CORD STIMULATION FOR REFRACTORY ANGINA PECTORIS
Author(s): ,
Murtazin, V.*
Affiliations:
Siberian Federal Biomedical Research Centre n. a. acad. E. N. Meshalkin, Neurosugergy, Novosibirsk, Russia
,
Ashurkov, A.
Affiliations:
Siberian Federal Biomedical Research Centre n. a. acad. E. N. Meshalkin, Neurosugergy, Novosibirsk, Russia
,
Kiselev, R.
Affiliations:
Siberian Federal Biomedical Research Centre n. a. acad. E. N. Meshalkin, Neurosugergy, Novosibirsk, Russia
,
Orlov, K.
Affiliations:
Siberian Federal Biomedical Research Centre n. a. acad. E. N. Meshalkin, Neurosugergy, Novosibirsk, Russia
,
Shabalov, V.
Affiliations:
Siberian Federal Biomedical Research Centre n. a. acad. E. N. Meshalkin, Neurosugergy, Novosibirsk, Russia
Krivoshapkin, A.
Affiliations:
Siberian Federal Biomedical Research Centre n. a. acad. E. N. Meshalkin, Neurosugergy, Novosibirsk, Russia
ESRA Academy. Murtazin V. Sep 13, 2017; 190770
Vladimir Murtazin
Vladimir Murtazin

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Abstract
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Background and Aims:

Refractory angina pectoris (RAP) is a chronic pain conditions caused by coronary artery diseases, which cannot be adequately controlled neither by combination of medical therapy nor by vascular surgery treatment (angioplasty or CABG). Spinal cord stimulation (SCS) is a neuromodulation therapy that appears to be an effective and safe treatment for these patients.

Methods:

We had applied SCS in 17 patients with RAP. The first step procedure was trial neurostimulation to reveal the efficacy of pain relief before the second step to implant the permanent SCS. Myocardium perfusion scintigraphy (MPS) was performed on admission, on the 7th day and in 1 year after procedure. The visual analogue scale (VAS) was used to assess the degree of pain both in rest and physical activity in all patients.

Results:

The patients showed 8,49±0,14 marks according VAS before the procedure and pain relief to 1,25±0,73 marks (p<0,01) after 1 year of procedure. All the patients demonstrated the rise of tolerance to the physical activity. MPS detected the decrement of perfusion's defect from 13,36±4,16 to 10,14±3,35 prearranged units (which means increase in coronary reserve up to 24%). The quality of life according to SAQ increased by 60,29% (TS scale - 58,12% amount of growth and PL scale - 64,65%). There were no any procedural complications. But we had registered 1 patient's death from cardiac infarction in one-year catamnesis.

Conclusions:

Our experience confirmes that SCS is a minimally invasive technique to reduce the pain and improve quality of life with vascular reserve enhancement in RAP patients.

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