Stellat ganglion blockage in the treatment of chronic refractory angina pectoris

In addition to medical approaches, laser revascularization, transmyocardial laser revascularization, angiogenesis, growth factor gene therapy, thoracic epidural anesthesia, and spinal cord simulation are used to treat chronic refractory angina pectoris. A unilateral left stellate ganglion block is another alternative. It may particularly be considered as a palliative intervention in patients with a short life span. Described here is the case of a 66-year-old male patient for whom a unilateral left stellate ganglion blockade was used to treat chronic refractory angina pectoris.

Kronik refrakter angina pektoris tedavisinde stellat ganglion blokajı

Kronik refrakter angina pektoris tedavisine medikal yaklaşım, lazer revaskülarizasyon, transmyokardial lazer revaskülarizasyon, angiogenesis, growth faktör gen terapisi, torakal epidural anestezi ve spinal kord simülatörü kullanılmakla birlikte, unilateral sol stellat ganglion blokajı bir alternatif olarak önerilmektedir. Özellikle yaşam süresi kısa olan hastalarda tercih edilebilecek bir palyatif bir girişim olarak düşünülmelidir. Bizde 66 yaşında erkek hasta son dönem kalp yetersizliği ile takip edilen ve kronik refrakter angina pektorisin tedavisinde unilateral sol stellat ganglion blokajı yapılan olguyu sunduk.

Kaynakça

1. McGillion M, Arthur HM, Cook A, Carroll SL, Victor JC, L’allier PL, et al. Management of patients with refractory angina: Canadian Cardiovascular Society/Canadian Pain Societyjoint guidelines. Can J Cardiol 2012;28(2 Suppl):S20–41.

2. Brorsson B, Bernstein SJ, Brook RH, Werkö L. Quality of life of patients with chronic stable angina before and four years after coronary revascularisation compared with a normal population. Heart 2002;87(2):140–5.

3. Chumburidze VB, Kharchilava NA, Aladashvili AV. The problem of chronic refractory angina pectoris. Georgian Med News 2005;(118):26–8.

4. Rajesh MC, Deepa KV, Ramdas EK. Stellate Ganglion Block as Rescue Therapy in Refractory Ventricular Tachycardia. Anesth Essays Res 2017;11(1):266–7.

5. Egawa H, Okuda Y, Kitajima T, Minami J. Assessment of QT interval and QT dispersion following stellate ganglion block using computerized measurements. Reg Anesth Pain Med 2001;26(6):539–44.

6. Sinem Sarı, Osman Nuri Aydın. Complication belong to Stellate ganglion blockade after cervical trauma. Agri 2014;26(2):97–100. [Article in Turkish]

7. Cousins MJ, Bridenbaugh PO. Neural Blockade. 3rd ed. NewYork: Lippincott- Raven; 1998. p. 411–47.

8. Schlack W, Schäfer S, Thämer V. Left stellate ganglion block impairs left ventricular function. Anesth Analg 1994;79(6):1082–8.

9. Saraste A, Ukkonen H, Varis A, Vasankari T, Tunturi S, Taittonen M, et al. Effect of spinal cord stimulation on myocardial perfusion reserve in patients with refractory angina pectoris. Eur Heart J Cardiovasc Imaging 2015;16(4):449–55.

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Stellat ganglion blockage in the treatment of chronic refractory angina pectoris

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