Liste-24

COST-EFFECTIVENESS OF SPINAL CORD STIMULATION FOR TREATMENT OF INTRACTABLE ANGINA IN AN AMERICAN PATIENT

Szabo CS

Purpose: Spinal cord stimulation (SCS) has been used for the treatment of intractable angina pectoris unresponsive to other treatments since 1985. Numerous peer-reviewed journal articles have documented the effectiveness of this technique. All previous articles have been studies published by European and Austrailian centers. The United States has an estimated population of 30,000 patients with intractable angina. This is the first report to describe the treatment of an American patient and compares the cost of care for two years prior to and two years after implantation.

Methods: Hospital and outpatient clinical and billing records were reviewed. Treatment costs before and after the implant were compared.

Results: SCS therapy provided an immediate improvement in the quality of life and requirements for medical care. In the two years prior to the implantation the patient had 11 hospitalizations totaling 90 days for treatment of angina. In the first two years of SCS treatment the patient had 3 hospital admissions for a total of 8 days for arrhythmia treatment but no admissions for chest pain. Outpatient records documented a resolution of intractable angina.

Conclusion: Treatment of intractable angina pectoris with SCS is a cost-effective and proven therapy under utilized in the USA. It is estimated that approximately 1000 angina patients are currently under treatment with SCS worldwide. Although, SCS is a popular treatment for chronic neuropathic pain in the USA, it has not been used for cardiac pain. Adding intractable angina pectoris to SCS indications in the USA would provide a significant cost-benefits.