Efficacy of Coronary Sinus Reducer in Patients With Non-revascularized Chronic Total Occlusions

Zivelonghi, Carlo; Verheye, Stefan; Timmers, Leo; Kuijk, J.P. van; Giannini, Francesco; Dekker, Mirthe; Silvis, Max J. M.; Abawi, Masieh; Leenders, Geert E.; Kortland, Friso; Tzanis, Giorgos; Beneduce, Alessandro; Benfari, Giovanni; Stella, Pieter R.; Henriques, José P.S.; Banai, Shmuel; Agostoni, Pierfrancesco

doi:10.1016/j.amjcard.2020.03.042

Cited by 26 publications

(12 citation statements)

References 14 publications

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“…With these limitations in mind, CSR might remain a valid alternative in patients with CTO lesions. A recent retrospective study showed greater symptom improvement (CTO 80.6% vs. no CTO 66.3%, p = 0.03) in RA patients with evident CTO lesions as compared to patients without CTO lesions [48]. Interestingly, symptoms improvement was also evident in patients with isolated right coronary artery (RCA) CTOs.…”

Section: Revascularization Of Chronic Total Occlusionsmentioning

confidence: 97%

Non-pharmacological Treatment of Refractory Angina and Microvascular Angina

Rakhimov

Gori²

2020

Biomedicines

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Refractory angina (RA) is defined as debilitating anginal symptoms despite the optimal guideline-directed combination of medical, percutaneous, and surgical therapies. Often referred to as “no option”, these patients represent a significant unmet clinical need for healthcare institutions. Due to the ageing of the population, and increased survival from coronary artery disease, the number of patients with RA is expected to rise exponentially. Despite the developments of novel technologies for the treatment of RA, none of them found wide clinical application (to date). Microvascular dysfunction, alone or in combination with epicardial coronary disease, is thought to contribute significantly to refractory angina. However, most of the techniques developed to improve RA symptoms have not been tested specifically on patients with microvascular dysfunction. This review discusses the recent developments in the treatment of RA, and gives some perspectives on the future of these techniques.

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Section: Revascularization Of Chronic Total Occlusionsmentioning

confidence: 97%

Non-pharmacological Treatment of Refractory Angina and Microvascular Angina

Rakhimov

Gori²

2020

Biomedicines

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“…After the first pre-clinical experiments in swine models supporting the safety and feasibility of CSR implantation, 21,27,35 further studies in humans investigated the efficacy of this device in improving quality of life and myocardial ischaemia in patients with refractory angina ( Table 1). 19,24,[36][37][38][39][40][41][42][43] CSR implantation was investigated for the first time in a non-randomised In a single-centre Italian study, 40…”

Section: Efficacy and Performance In Clinical Studiesmentioning

confidence: 99%

The Coronary Sinus Reducer – Clinical Evidence and New Perspectives On An Emerging Tool in the Treatment of Refractory Angina

Zivelonghi¹,

Verheye²

2020

Heart International

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“…1 However, 15% to 30% of patients who undergo Reducer implantation do not derive any symptomatic relief, so called "nonresponders." [2][3][4][5] Current demographic trends predict an increase in this cohort, highlighting the importance of understanding potential mechanisms underlying Reducer non-responsiveness. One possible mechanism may relate to the significant anatomical heterogeneity observed in CS size.…”

Section: Introductionmentioning

confidence: 99%

Coronary sinus size and ischemia improvement after reducer implantation; “one size to fit them all?”

Tzanis

Khokhar

Ponticelli

et al. 2021

Cathet Cardio Intervent

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Aim: Coronary sinus (CS) reducer implantation is associated with symptomatic relief of patients with refractory angina. However, 15% to 30% of the patients do not respond to this treatment. Aim if this study was to evaluate the effect of CS size in the effectiveness of the device.Methods: Prior to device implantation and at 4-month resting ventricular function was assessed by stress cardiac magnetic resonance. Ischemia was assessed by the myocardial perfusion reserve index (MPRI).Results: Fifteen patients (66 ± 10 years) underwent successful CS Reducer implantation, with improvements in angina class and exercise tolerance. Patients with a smaller CS size (<5.8 mm) presented a significantly higher percentage increase in MPRI (63 ± 51 vs 9 ± 30%, P = .03) and a higher reduction in left ventricle enddiastolic volumes.Conclusions: Greater benefits, in terms of ischemia improvement, after CS Reducer implantation were seen in patients with smaller CS sizes, suggesting a potential mechanism underlying the observed rates of reducer nonresponsiveness.

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Efficacy of Coronary Sinus Reducer in Patients With Non-revascularized Chronic Total Occlusions

Cited by 26 publications

References 14 publications

Non-pharmacological Treatment of Refractory Angina and Microvascular Angina

Non-pharmacological Treatment of Refractory Angina and Microvascular Angina

The Coronary Sinus Reducer – Clinical Evidence and New Perspectives On An Emerging Tool in the Treatment of Refractory Angina

Coronary sinus size and ischemia improvement after reducer implantation; “one size to fit them all?”

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