Spinal cord stimulation for refractory angina pectoris and nonreconstructable chronic critical leg ischemia

Spinal cord stimulation (SCS) is an underused treatment option for patients with refractory angina pectoris (RAP) and nonreconstructable chronic critical leg ischemia (NR-CCLI) in the United States. Multiple studies have demonstrated significant pain relief with SCS, and an increase in activities of daily living, decreased medication use, improved blood flow to the lower extremities, and trend toward a better amputation-free salvage. SCS is reviewed in depth as a treatment option for both RAP and NR-CCLI. There are multiple treatment benefits for patients with RAP and NR-CCLI who undergo SCS, with infrequent adverse events, which include lead migration and infection. SCS has yet to be a frequently employed treatment modality for patients with RAP and NR-CCLI in the United States. With further collaboration and communication between pain physicians, neurosurgeons, cardiologists, internists, vascular surgeons, and other healthcare providers, patients suffering from RAP or NR-CCLI may benefit from SCS therapy.