Coronary sinus reducer for the treatment of chronic refractory angina pectoris.

Refractory angina represents the final stage of chronic coronary artery disease, where anginal symptoms persist despite complete epicardial coronary artery revascularization and maximally tolerated pharmacological therapy. Percutaneous narrowing of the coronary sinus with the coronary sinus reducer (Reducer Coronary sinus reducer device implantation is a therapeutic option for patients suffering from chest tightness, discomfort and pain (collectively named angina when of clear cardiac origin), which persist for a long time despite optimal medical therapy and complete coronary revascularization. This is a novel device designed to be implanted, via a small puncture on the side of the neck, into the largest cardiac vein (i.e., the coronary sinus), to slow the outflow of blood from the cardiac venous system. Treatment is associated with significant improvement of symptoms in about 70–85% of patients, while granting little or no benefit in the remaining 15–30% for reasons that are yet to be determined. Importantly, the procedure has been shown to be safe and to have a very low rate of complications. Patients should keep this in mind when evaluating this therapeutic option.