[the Coronary Sinus Reducer: a Device-based Therapy for Refractory Angina].

INTRODUCTION Alongside the remarkable progress in therapeutic strategies destined to patients with coronary artery disease (CAD), a growing number of patients who suffer from severe and diffuse CAD not amenable for revascularization, continue to experience severe debilitating angina despite optimal medical therapy. The Coronary Sinus (CS) Reducer has emerged as a novel therapeutic strategy for patients with refractory angina pectoris. The Reducer is a stainless steel, balloon-expandable, hourglass shaped device implanted percutaneously through the right internal jugular vein in the coronary sinus. After implantation it creates a controlled narrowing of the lumen, leading to an increase in coronary venues pressure, which improves blood flow to ischemic layers of the myocardium by redistribution of blood from the subepicardial myocardium to the more ischemic subendocardial layers of the myocardium, thus improving angina symptoms and quality of life.