Neovasc Reducer™: clinical results in microvascular angina

The Neovasc Reducer™ system is an implantable device, designed to create a permanent and controlled narrowing of the coronary sinus aimed at improving perfusion of ischemic regions in the myocardium in patients with reversible ischemic cardiomyopathy. The Reducer ™ is for use in patients, often defined “no options”, who have refractory angina pectoris associated with proven reversible myocardial ischemia, with limited treatment options (no more candidates for revascularization, optimal medical therapy).

The outcomes of randomized clinical trial COSIRA (N Eng J Med 2015), together with the results of several observational studies, have shown the safety and efficacy of the Reducer™ device use according to these indications.

It has been clinically studied the use of The Neovasc Reducer™ system in a different patients subgroup with refractory angina and evidence of myocardial ischemia that persists despite optimal medical therapy and angiographically successful percutaneous revascularizations (PCI). Coronary microvascular dysfunction (microvascular angina) seems to be one of the underlying pathophysiological mechanisms.

Recently, during GISE 2018 congress, Dr. Giannini presented the results of 8 patients who underwent compassionate CS Reducer™ implantation for the treatment of refractory angina. The study results have been published on JACC Cardiovascular Interventions (volume 10, No. 18, 2017 – September 25, 2017: 1899-903) and showed positive data in terms of improvement of CCS class, Seattle Angina Questionnaire and physical limitation (6 minutes walking test).

These results are certainly an encouraging first step in the more extensive and complete evaluation of the effectiveness of controlled flow reduction in the coronary sinus, which could be an option for this pathological condition of complex management.

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