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Refractory angina pectoris is a condition characterized by the presence of debilitating angina symptoms despite optimal medical therapy due to severe and/or diffuse coronary artery disease not amenable for revascularization either by percutaneous or surgical approach. The coronary sinus Reducer is a percutaneous device designed to increase coronary sinus pressure to achieve a redistribution of the arterial coronary blood flow from the sub-epicardial layers towards the ischemic sub-endocardium in patients with refractory angina. The aim of this review is to provide a description of the Reducer, to report results from clinical studies available up to date and to discuss about future employment and perspectives.

The coronary sinus reducer: a validate option for “no-option” labeled patients. Clinical evidences and new perspectives