The aim of this study was to investigate the safety and efficacy of the two most commonly practiced temporary sympathectomy techniques in the treatment of chronic refractory angina. Fifty-nine consecutive refractory angina patients commencing outpatient temporary sympathectomy from November 1, 2000 to November 1, 2002, were prospectively audited for duration of pain relief and procedural complications over a two-year period. A total of 227 stellate ganglion blockades (SGB) and 100 paravertebral blockades (PVB) were performed on 59 chronic refractory angina (CRA) patients naïve to sympathectomy. The mean period of pain relief obtained following SGB was 3.48 weeks (SD 3.38) and the mean relief following PVB was 2.80 weeks (SD 2.00). Mild, fully reversible complications occurred in 3% of SGB and 3% of PVB procedures, with one patient requiring overnight hospitalization. This study demonstrates that temporary sympathectomy may provide a safe and effective outpatient procedure in refractory angina patients when applied as part of holistic care.
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http://dx.doi.org/10.1016/j.jpainsymman.2005.02.016 | DOI Listing |
J Cardiovasc Dev Dis
November 2024
Robert Bosch Krankenhaus, Department of Cardiology and Angiology, Auerbachstr. 110, 70376 Stuttgart, Germany.
Gender medicine has increasingly underscored the necessity of addressing sex-based differences in disease prevalence and management, particularly within cardiovascular conditions and drug intolerance. Women often present cardiovascular diseases distinctively from men, with a higher prevalence of non-obstructive coronary artery disease and varied ischemic manifestations, such as coronary microvascular dysfunction and epicardial or microvascular coronary spasm. This disparity is further exacerbated by elevated drug intolerance rates among women, influenced by hormonal, genetic, and psychosocial factors.
View Article and Find Full Text PDFEur Heart J Case Rep
December 2024
Cardiac Electrophysiology and Electrostimulation Unit, San Pietro Fatebenefratelli Hospital Rome, Via Cassia, 600, 00189 Rome, Italy.
Background: The coronary sinus reducer (CSR) is a therapeutic option for patients with coronary artery disease who are not eligible for further revascularization and experience refractory angina. Cardiac resynchronization therapy (CRT) improves symptoms and prognosis in heart failure with reduced ejection fraction, but the presence of a CSR may complicate left ventricular lead placement. Only four cases have been reported so far in this context.
View Article and Find Full Text PDFCardiovasc Revasc Med
December 2024
Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Sydney Street, Chelsea, London SW3 6NP, UK; National Heart and Lung Institute, Imperial College London, UK. Electronic address:
Background: Coronary sinus reducer (CSR) implantation is emerging as a novel effective percutaneous therapy for patients with refractory angina. Limited data exists examining the factors influencing successful CSR implantation. As CSR implantation becomes more widely adopted, a greater understanding of the procedural challenges which operators encounter is required.
View Article and Find Full Text PDFSemin Thorac Cardiovasc Surg
December 2024
Department of Surgery, Division of Cardiac Surgery, The Ohio State University, Columbus, Ohio. Electronic address:
Refractory angina is a debilitating disease with limited therapeutic options that is primarily caused by microvascular dysfunction and desertification. Towards addressing this unmet need, microvascular revascularization therapy has progressively evolved from the lizard heart inspired transmyocardial revascularization to precisely inducing vascular endothelial growth factor with gene therapy. Gene therapy with adenoviral vehicles or naked modified ribonucleic acid is safe and shows early signs of clinical promise but has not yet been proven effective due to gaps in optimization.
View Article and Find Full Text PDFZh Vopr Neirokhir Im N N Burdenko
December 2024
JSC «K+31», Moscow, Russia.
Objective: To analyze the structure of care for patients with pain syndromes in the Russian Federation and possible improvement of these approaches.
Material And Methods: A detailed questionnaire was sent to 60 pain clinics. We received responses from 40 hospitals.
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