The Coronary Sinus Reducer; 5-year Dutch experience

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Refractory angina affects millions globally, posing a significant healthcare challenge.
• The Coronary Sinus Reducer (CSR) is an innovative device aimed at alleviating refractory angina symptoms.
• CSR functions by increasing venous pressure, promoting arteriolar dilation and reducing sub-endocardial vascular resistance.

Purpose of the Study:

• To evaluate the 5-year safety and efficacy of the Coronary Sinus Reducer (CSR) in Dutch patients.
• To assess the impact of CSR implantation on Canadian Cardiovascular Society (CCS) class in refractory angina patients.

Main Methods:

• A cohort of 132 patients with refractory angina received CSR treatment.
• Efficacy was measured by CCS class improvement at 6-month follow-up.
• Safety was assessed by successful CSR implantation and absence of device-related events.

Main Results:

• Significant improvement in CCS class was observed, with 67% of patients showing at least a one-class improvement and 34% showing at least a two-class improvement.
• Mean CCS class decreased from 3.17 to 2.12 (P < 0.001).
• Successful CSR implantation was achieved in 99% of patients with only minor complications reported.

Conclusions:

• The Coronary Sinus Reducer (CSR) presents a simple, safe, and effective therapeutic option for the majority of refractory angina patients.
• Approximately 30% of patients did not experience benefits from CSR implantation.
• Future research should investigate the mechanisms of action and reasons for non-response to optimize patient selection for CSR therapy.