The Coronary Sinus Reducer - Clinical Evidence and New Perspectives On An Emerging Tool in the Treatment of Refractory Angina.

The coronary sinus reducer represents an emerging therapeutic option for patients suffering from chronic refractory angina. Current data indicate that the population suffering from angina symptoms despite maximal medical therapy and maximal achievable revascularisation - surgical or percutaneous - is constantly increasing. Also, the clinical outcome for these patients is strongly affected by the lack of adequate treatment, the occurrence of adverse events and the need for repeated hospitalisation. Growing evidence supports the clinical benefits of the coronary sinus reducer in relieving angina symptoms in this specific population, with emerging evidence of reduction in myocardial ischaemia following the implantation of the coronary sinus reducer. In this review, we provide an up-to-date description of the role of this relatively new device in the treatment of refractory angina, focusing not only on symptom relief but also on the increasing data that supports objective improvements in myocardial ischaemia.