Clinical observations on the use of the coronary sinus reducer for managing refractory angina pectoris: Insights from a single center case series
Bibliographic record
Abstract
Abstract Background Managing patients with refractory angina pectoris (RAP) remains challenging, as conventional therapies often provide insufficient relief. The Coronary Sinus Reducer (CSR) is a novel therapeutic device designed to alleviate symptoms in these patients. The CSR creates a focal narrowing in the coronary sinus, purportedly improving myocardial perfusion in ischemic territories. Objective To assess the procedural safety and clinical efficacy of the CSR device in a real-world cohort of patients with RAP treated at a single centre. Methods A retrospective analysis was conducted on 16 patients diagnosed with RAP who underwent treatment with CSR implantation between December 2020 and December 2024. Pre- and post-procedural evaluation was performed by stress myocardial perfusion imaging, nitrate consumption, the Canadian Cardiovascular Society (CCS) angina grading scale, six-minute walk test and a self-reported questionnaire for assessing health-related quality of life (HRQoL). Results CSR device was successfully implanted in 14 patients (men=13, mean age 68±7.7 years). One patient could not receive the device due to anatomical challenges, and another experienced device dislodgement during optimization of positioning which was removed uneventfully. No major adverse cardiac events were reported during following year. Hospital readmissions due to anginal symptom occurred in five patients between three and eight months after implantation. At follow up (mean±SD: 5±1.3 months), 50% used less nitrates and 50 % improved by one CCS class. No patient deteriorated in functional class. The walking distance increased on average by 18 m (SD 43) with a maximum gain of 81 m. The HRQoL scores improved in the subscales of bodily pain and social function. Conclusions In this case series, CSR treatment demonstrated a favorable safety profile with infrequent and manageable adverse events. The therapy led to a reduction in nitrate consumption and CCS class, alongside improvements in physical and social capacity for a substantial proportion of patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".