Professional literature:

Stable chronic angina is a common disease, that continues to exist despite optimal drug therapy, in patients undergoing therapeutic catheterizations or coronary bypass surgery. According to the literature, every fourth patient will suffer from this disease, which causes significant functional limitations and repeated seeking of medical help.Subcutaneous transplantation of Reducer in the coronary artery is an innovative, safe, and effective treatment option for patients with stable chronic angina

The Reducer creates a controlled narrowing of the coronary vein that causes a downward pressure on its face. The increase in blood pressure in the venous drainage system, followed by the expansion of the radius in the capillaries and in the arterioles of the myocardial layers close to the left ventricle (the heart muscle in the sub-endocardial region) leads to an improvement in blood flow to those myocardial layers that suffer from ischemia, thereby improving the symptoms of angina, improving functional level and the ability to perform physical activity / exertion. The subjective clinical improvement following Reducer transplantation can also be measured via objective means, as has been shown and published in several scientific papers, some of which are detailed below:

Verheye S, Jolicœur EM, Behan MW, et al. Efficacy of a Device to Narrow the Coronary Sinus in Refractory Angina. N. Engl. J. Med. 2015;372:519–527

Banai S, Ben Muvhar S, Parikh KH, et al. Coronary Sinus Reducer Stent for the Treatment of Chronic Refractory Angina Pectoris. A Prospective, Open-Label, Multicenter, Safety Feasibility First-in-Man Study. J. Am. Coll. Cardiol. 2007;49:1783–1789

Mukherjee D. Management of refractory angina in the contemporary era. Eur. Heart J. 2013;34:2655–2657

Giannini F, Aurelio A, Jabbour RJ, Ferri L, Colombo A, Latib A. The coronary sinus reducer: clinical evidence and technical aspects. Expert Rev. Cardiovasc. Ther. 2017;15:47–58

Konigstein M, Giannini F, Banai S. The Reducer device in patients with angina pectoris: mechanisms, indications, and perspectives. Eur. Heart J. 2017;209:122–130

Abawi M, Nijhoff F, Stella PR, et al. Safety and efficacy of a device to narrow the coronary sinus for the treatment of refractory angina: A single-centre real-world experience. Neth. Heart J. 2016;24:544–51

Giannini F, Baldetti L, Ielasi A, et al. First Experience With the Coronary Sinus Reducer System for the Management of Refractory Angina in Patients Without Obstructive Coronary Artery Disease. JACC Cardiovasc. Interv. 2017;10:1901–1903

Spertus JA, Winder JA, Dewhurst TA, et al. Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease. J. Am. Coll. Cardiol. 1995;25:333–41

Konigstein M, Meyten N, Verheye S, Schwartz M, Banai S. Transcatheter treatment for refractory angina with the coronary sinus Reducer. EuroIntervention 2014;9:1158–1164

Baldetti L, Colombo A, Banai S, et al. Coronary sinus Reducer non-responders: insights and perspectives. EuroIntervention 2017. Available at: Accessed December 3, 2017

 First Experience With the Coronary Sinus Reducer System for the Management of Refractory Angina in Patients Without Obstructive Coronary Artery Disease. Giannini F, Baldetti L, Ielasi A, Ruparelia N, Ponticelli F, Latib A, Mitomo S, Esposito A, Palmisano A, Chieffo A, Colombo A. JACC Cardiovasc Interv. 2017 Sep 25;10(18):1901-1903. doi: 10.1016/j.jcin.2017.06.062.

Alternative interventions for refractory angina. Sainsbury PA, Fisher M,  de Silva R. Heart. 2017 Dec;103(23):1911-1922

Coronary sinus Reducer implantation for the treatment of chronic refractory angina: a single center experience .Francesco Giannini, MD, Unit of Cardiovascular Interventions, IRCCS San Raffaele Scientific Institute, Milan, Italy. JACC: CARDIOVASCULAR INTERVENTIONS 091417,

Coronary Sinus Reducer implantation improves symptoms ,ischemia and physical capacity in patients with refractory angina unsuitable for myocardial revascularization :A Single Center Experience. Konigstein M,Bazanm S,Revivo  M ,Banai S. EuroIntervention 2018;    Jaa-362 2018,   doi:10.4244/EIJ-D-18-00102