An entirely predictable consequence of medical progress is the growing number of heart patients with persistent and symptomatic angina who have run out of treatment options. A small study published in the New England Journal of Medicine raises the possibility that a new and novel device one day may provide them some relief. The experimental device, called the Neovasc Reducer, is a coronary sinus reducer system. It is delivered through a catheter to the coronary sinus, where it is then expanded with a balloon, blocking flow through most of the vessel except for a small central orifice. Once in place the device causes an increase in coronary sinus pressure that appears to relieve angina, though the authors acknowledge that the “physiological rationale for a beneficial effect… remains unclear.”
Investigators in the Coronary Sinus Reducer for Treatment of Refractory Angina (COSIRA) trial studied 104 patients with angina class III or IV angina who were not considered suitable candidates for revascularization.
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