Does the Coronary Sinus Reducer Decrease Ischemia and Angina in Patients with Stable Coronary Disease?

The coronary sinus reducer (CSR) is a stainless-steel mesh device that is placed in the coronary sinus to decrease angina. It is thought to work by redistributing myocardial perfusion, although this hypothesis has not been rigorously tested. The CSR has a class IIb European guideline recommendation for patients with angina and no further options for antianginal management but is not endorsed in the 2023 U.S. chronic coronary artery disease guideline. The device received a breakthrough therapy designation from the FDA in 2020.

In a randomized, double-blind, placebo-controlled trial conducted in the U.K. (NCT04892537), investigators assessed whether CSR improved myocardial perfusion and angina symptoms among patients with angina, epicardial di…