Background and aims: Spinal Cord Stimulation (SCS) alleviates angina symptoms and improves health related quality of life in patients with refractory angina. However, there are few long-term studies assessing SCS treatment-related complications in patients with refractory angina. The aim of this study was to assess SCS treatment-related complications in patients with refractory angina.
Methods: All patients referred for SCS treatment at 10 European centres during 2003-2005 were consecutively included in the prospective study “European Angina Registry Link” (EARL). A permanent SCS system was implanted in 121 patients and the patients were followed up to 3 years. Complications associated with SCS treatment were registered prospectively.
Results: In total, 44 out of 121 patients reported one or more SCS treatment-related complication. There were 67 complications and 61 of these required re-operation. The majority of complications (n=59, 88 %) were resolved. Most complications were technical, i.e. related to device use, including lead migrations (n=14), lead fractures (n=12) and IPG (implantable pulse generator) dysfunctions (n=20). Most common non-technical complications were pain over implantation site (n=8) and infection (n=3). There were 40 pre-term study terminations, of which the majority were due to death (n=23, 19%). 
Conclusions: SCS treatment-related complications are common in patients with refractory angina but the majority of them can be resolved through revision surgery. This should be considered in preoperative evaluation and patient information. Patients with refractory angina treated with SCS require careful follow-up regarding both angina symptoms and SCS treatment for optimal efficacy.

SPINAL CORD STIMULATION FOR REFRACTORY ANGINA PECTORIS - A 3-YEAR FOLLOW-UP STUDY OF TREATMENT-RELATED COMPLICATIONS