Cost-Effectiveness of Spinal Cord Stimulation versus Coronary Artery Bypass Grafting in Patients with Severe Angina Pectoris – Long-Term Results from the ESBY Study

Abstract

The present study is a 2-year follow-up of the 104 patients participating in the ESBY study (Electrical Stimulation versus Coronary Artery Bypass Surgery in Severe Angina Pectoris), a randomised prospective study including patients with increased surgical risk and no prognostic benefit from revascularisation. Hospital care costs, morbidity and causes of death after spinal cord stimulation (SCS) and coronary artery bypass grafting (CABG) were assessed, as well as the complication rate of SCS treatment. SCS proved to be a less expensive symptomatic treatment modality of angina pectoris than CABG (p < 0.01). The SCS group had fewer hospitalisation days related to the primary intervention (p < 0.0001) and fewer hospitalisation days due to cardiac events (p < 0.05). The groups did not differ with regard to causes of death. There were no serious complications related to the SCS treatment.

Enhanced External Counterpulsation in the Treatment of Chronic Refractory Angina: A Long‐term Follow‐up Outcome from the International Enhanced External Counterpulsation Patient Registry

“…19 The 3-year mortality rate observed in our study is similar to that of a group of patients suffering from CCS IV angina and treated medically, or high-risk CABG candidates who had nonprognostic coronary lesions and received CABG or spinal cord stimulation. 20,21 Consistent with previous studies, the rate of revascularization in our study is high. 20 This reflects the dynamic nature of atherosclerosis that existing lesions may progress and new lesions may develop over time.…”

Long-term effects of spinal cord stimulation on angina symptoms and quality of life in patients with refractory angina pectoris--results from the European Angina Registry Link Study (EARL)

“…The implantation technique has been previously described 13 24. The permanent device was programmed after the implantation.…”

Stroke and Encephalopathy After Cardiac Surgery

“…In the United States, preoperative MRI has been difficult to obtain because of the short time between hospital admission and surgery. 35 Thus, it has been difficult to demonstrate an association between the degree of preexisting vascular disease and neurological outcomes. However, in a study from Japan in which MRI scans were obtained before surgery in 421 CABG candidates, 36 30% of patients had small brain infarctions and 20% had multiple infarctions.…”