Implant Offers Relief for Refractory Angina Patients, Largest Study Finds
A new study finds a coronary sinus reducer implant significantly reduces chest pain in 75% of refractory angina patients within six months, offering hope for thousands in England.
The device, called a coronary sinus reducer (CSR), is implanted using keyhole surgery through the patient's neck. It works by narrowing a vein at the back of the heart, which helps redirect blood flow to parts of the heart muscle that are getting too little oxygen. The study, the largest of its kind worldwide, followed 491 people with refractory angina between 2014 and 2024. Of these, 474 had the implant fitted at 19 hospitals in England and Scotland.
Most patients went home the day of the procedure or the day after, and serious complications were rare. The study was co-led by consultant cardiologist Dr Ranil de Silva of Royal Brompton Hospital in London, a specialist NHS heart and lung center. He described the device as "potentially a gamechanger" for patients whose symptoms persist despite drugs, stents, and bypass surgery.
One patient, Cristian Jensen, a 64-year-old packaging designer, received the implant in 2021 after decades of heart problems. He used to have five angina attacks a week, each involving a sharp, acute pain that reminded him of his previous heart attack. Now he has an attack every week or two, and he no longer worries about climbing stairs or taking on strenuous exercise.
"It's an amazing relief, both physically and emotionally, to be able to live my life again normally, without feeling that I'm limited all the time in what I can do," Jensen told The Guardian.
Jensen's history includes a diagnosis of angina at age 28, open heart surgery that kept him angina-free for 17 years, a heart attack in 2007, and eight stents. He also takes medication for high cholesterol and uses a GTN spray to relieve pain during attacks. He was one of only a handful of patients to receive the experimental treatment despite the large number of people with refractory angina.
Dr de Silva said many patients report their lives being transformed. "They get their life back," he said. However, he cautioned that it is too early to see CSR as a standard treatment. More trials are needed, and the NHS must approve funding to expand access.
Dr Sonya Babu-Narayan, consultant cardiologist and clinical director at the British Heart Foundation, said the findings are reassuring because they show the device is being delivered safely and results in fewer symptoms. She added that the device "offers hope for people living with this challenging condition."
Each device costs the NHS £11,400.