Patient information
Persistent angina &
the coronary sinus reducer
A careful review of symptoms and previous treatment is the starting point.
What is refractory angina?
Refractory angina describes angina that remains troublesome despite treatment. Some people have coronary artery narrowing that is difficult to treat with stents or bypass surgery. Others may have problems with the small blood vessels of the heart or coronary artery spasm.
Chest pain can also have causes outside the heart. Reviewing the diagnosis, previous procedures and medicines is an important part of assessing persistent symptoms.
What is a coronary sinus reducer?
The coronary sinus reducer is an hourglass-shaped implant placed in the main vein draining blood from the heart muscle. It is different from a conventional coronary stent, which is placed in an artery. The reducer is intended to help relieve symptoms in selected people with refractory angina.
It is implanted using a catheter, usually through a vein in the neck. Creating a narrowing in the coronary sinus changes the pressure in the heart’s venous circulation.
Who might be considered?
A specialist assessment is needed to review the cause of symptoms and whether other treatments may help. Further testing can include a scan to assess the blood supply to the heart muscle and, in some cases, another angiogram.
Medication changes or a different coronary intervention may be more appropriate. Treatment with a reducer does not help everyone, and an improvement in symptoms cannot be guaranteed.
Benefits & risks
Any possible benefit needs to be weighed against the risks of an invasive procedure. These, the alternatives, and the evidence relevant to your circumstances would be discussed before a decision is made.
Current availability
Access to a coronary sinus reducer depends on your type of angina, previous treatment and suitability following specialist assessment. The options available may differ between patient groups.
- NHS care: Availability is currently limited and depends on local services and funding arrangements.
- Research trials: Some patients may be able to access treatment through a clinical trial, depending on eligibility and whether a suitable study is recruiting.
- Private treatment: This may be an option for selected patients, subject to clinical suitability, service availability and confirmation of costs or insurance cover.
We would discuss which options, if any, are available for your circumstances. An assessment or private consultation does not guarantee access to the procedure.
Further reading: NICE guidance on coronary sinus narrowing device implantation.
Private appointments
Let’s talk about your heart health.
Arrange a consultation through the Rowan Suite at Liverpool Heart and Chest Hospital.
The Rowan Suite · Liverpool Heart and Chest Hospital