Spinal Cord Stimulation for Long-term Treatment of Severe Angina Pectoris

What Does the Evidence Say?

Mats Börjesson; Paulin Andréll; Clas Mannheimer


Future Cardiol. 2011;7(6):825-833. 

In This Article

Efficacy Compared With Other Treatment Modalities

As there is a lack of distinct patient selection criteria for the different treatment options for refractory angina, direct comparisons of efficacy on cost–effectiveness are difficult. However, we believe the available comparative studies add important information.

The systematic review and meta-analysis by Taylor et al. , published in 2009, concludes that SCS is an effective and safe treatment option for the management of refractory angina pectoris.[36] In addition, SCS was found to be of similar efficacy and safety to the treatment alternative of PMR. The authors concluded that the results of the meta-analysis support the current treatment recommendations (AHA/American College of Cardiology) regarding SCS in severe angina pectoris, and thereby also supports the more widespread use of SCS for the management of refractory angina.[36]

A third, recent UK review, published in Health Technology Assessment, concluded that for severe angina pectoris, SCS was more effective than PMR at 3 months, but not at 12 months, in increasing the time to angina, while the effect on quality of life were similar.[47] According to this review, SCS is more effective than no SCS/inactive device in delaying time to angina and reducing nitrate consumption (symptom relief), as demonstrated in the short-term follow-up.[47]


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