New hope for refractory angina sufferers

Heart health

Angina pain can be reduced and other myocardial functions improved with an innovative new treatment offered by Royal Brompton Hospital

Royal Brompton & Harefield Hospitals Specialist Care is offering an innovative new treatment for refractory angina.

Refractory angina is becoming more prevalent as people live longer after treatments. The new Neovasc Reducer procedure offers hope to many patients who were previously given pain management as their only option, enabling them to enjoy normal lives again.

The procedure involves inserting a small device called the Neovasc Reducer. This narrows the coronary sinus to reduce symptoms and improve quality of life for patients who were often told there were no other options for them. The procedure takes approximately 20 minutes, with patients often discharged within 24 hours. It can take up to six months for the patient to feel the full benefits of the treatment.

As of August 2015, Royal Brompton & Harefield Hospitals is one of a few centres in the world to offer this service, as it is not yet available in the US.

The device received a CE mark in late 2011. The first-in-man study of the Reducer, which followed 15 patients for three years, demonstrated excellent safety and efficacy in terms of reducing angina pain and other improvements in myocardial function.

Royal Brompton Hospital consultant cardiologist Dr Ranil De Silva is able to perform the Neovasc Reducer procedure at Royal Brompton Hospital. Dr De Silva was involved in the clinical trials and wrote a paper on the procedure which was printed in the New England Journal of Medicine on 5 Feb 2015.

For people interested in this treatment, the first step is to determine whether or not they are suitable through an assessment from our team. This can either be carried out in person, or by sending bloodwork, a recent angiogram and an MRI perfusion scan or stress echo to the assessment team. From there, the team could recommend this procedure. The length of stay is approximately one week.

What is angina?

Angina is a pain that comes from the heart. Angina occurs when fatty deposits develop in the coronary arteries, causing a temporary shortage of blood to the heart muscle. This can be treated in different ways, including medication, coronary angioplasty, or bypass surgery.

Patients can continue to experience or have recurrence of angina, despite having had treatment with medication, stents, and coronary artery bypass surgery. This is called refractory angina. Each year about 20,000 people in the UK develop angina for the first time. It is more common in people over the age of 50, and more commonly found in men than women.


Dr Ranil de Silva

Consultant Cardiologist

Dr De Silva’s clinical expertise is in coronary angioplasty, and the management of acute coronary syndromes and advance coronary artery disease. He is a lead clinical investigator at the National Institute for Health Research (NIHR) cardiac regeneration unit based at the Trust.