Narrowing of the Coronary Sinus: A Device-Based Therapy for Persistent Angina Pectoris

Maayan Konigstein, Stefan Verheye, E. Marc Jolicœur, Shmuel Banai

Research output: Contribution to journalReview articlepeer-review

Abstract

Alongside the remarkable advances in medical and invasive therapies for the treatment of ischemic heart disease, an increasing number of patients with advanced coronary artery disease unsuitable for revascularization continue to suffer from angina pectoris despite optimal medical therapy. Patients with chronic angina have poor quality of life and increased levels of anxiety and depression. A considerable number of innovative therapeutic modalities for the treatment of chronic angina have been investigated over the years; however, none of these therapeutic options has become a standard of care, and none are widely utilized. Current treatment options for refractory angina focus on medical therapy and secondary risk factor modification. Interventions to create increased pressure in the coronary sinus may alleviate myocardial ischemia by forcing redistribution of coronary blood flow from the less ischemic subepicardium to the more ischemic subendocardium, thus relieving symptoms of ischemia. Percutaneous, transvenous implantation of a balloon expandable, hourglass-shaped, stainless steel mesh in the coronary sinus to create a fixed focal narrowing and to increase backwards pressure, may serve as a new device-based therapy destined for the treatment of refractory angina pectoris.

Original languageEnglish
Pages (from-to)238-243
Number of pages6
JournalCardiology in Review
Volume24
Issue number5
DOIs
StatePublished - 1 Sep 2016

Keywords

  • Coronary sinus
  • Persistent angina
  • Reducer
  • Refractory angina
  • angina pectoris

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