Radiosurgery of Ganglion StELlatum In Patients With REFractory Angina Pectoris

Inclusion Criteria: * 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. Exclusion Criteria: * Life expectancy less than 24 months * Non-responders of anesthetic blockade of GS * Impossibility to undergo a stress test. * Myocardial infarction in last 4 weeks * Heart failure - class IV NYHA * Unwillingness to participate or inability to comply with the protocol for the duration of the study * Patients who are pregnant, and patients with reproductive capability will need to use adequate contraception during the time of participation in the study * History of radiotherapy in the head and neck region