Radiosurgery of Ganglion StELlatum In Patients With REFractory Angina Pectoris
The core hypothesis to be tested is that the radiosurgery of stellate ganglion (left one or both if left-sided without full relief of symptoms) is an effective therapy of refractory angina pectoris in patients with no other therapeutic options - proof of concept study.
• Patients must have coronary artery disease (CAD) with refractory angina pectoris (AP).
• Patients must have a maximum of tolerated medication therapy of angina pectoris available.
• Patients must have done the maximum possible revascularization of CAD.
• Two certificated independent interventional cardiologists and two cardiac surgeons must conclude that further revascularization (including CABG) is not possible/not effective/ with high risk.
• Age ≥ 18 years.
• Patients must have any stress test with proof of myocardial ischemia (dobutamine echocardiography, gated Tc-SPECT of myocardium).
• Life expectancy at least 24 months (not limited due to severe comorbidities)
• Patients must be responders of anesthetic blockade of the left stellate ganglion (GS) - clinically significant relief of AP symptoms after blockade at least twice.
• Patients must provide verbal and written informed consent to participate in the study.