[Pneumatic external counterpulsation--a therapy option in angina pectoris]

Pneumatic external counterpulsation operates by applying ECG-triggered diastolic pressure via cuffs to the vascular bed of the lower limbs. Comparable with intra-aortic balloon pumping, PECP produces a diastolic augmentation combined with increase of mean arterial pressure and coronary perfusion. American, Asian, and our own data demonstrated a reduction of angina pectoris through repeated use of PECP one or two hours daily for four to seven weeks. Exercise testing and thallium scanning confirmed the clinical improvement. PECP is a virtually risk-free treatment option in patients suffering from angina despite medical and interventionell treatment. Opening of collaterals and collateral growth induced by external counterpulsation are discussed as the cause of clinical benefit.