Role of enhanced external counterpulsation in angina treatment

Enhanced external counterpulsation (EECP) is a noninvasive procedure in which compressions are applied to the vascular beds within the muscles of the legs, thighs, and buttocks in a sequential manner, progressing from the calves upward. Prompted by favorable results with EECP in Chinese angina patients, we studied the efficacy of the technique in 18 patients with chronic stable angina and evidence of exertional ischemia by thallium-201 perfusion imaging. Patients received 1 hour of EECP therapy daily for a total of 36 hours. Treatment with EECP produced substantial improvements in symptoms in all 18 patients and reduced myocardial ischemia, as assessed by thallium scanning, in 14 patients. Follow-up of 17 patients showed that the subjective and objective benefits of EECP were maintained for at least 3 years in most patients. In selected angina patients, EECP should be seriously considered as part of the treatment program.