A-Flux: a novel self-expanding coronary sinus reducer for refractory angina

Current transcatheter coronary sinus (CS) reducer technology is associated with significant improvement in symptoms and quality of life in patients with refractory angina1. However, its design and technology have some limitations, such as a “1-stop” deployment opportunity, limited device sizing, risk of dislodgement during balloon retrieval, and reliance on endothelialisation for its therapeutic effect23.

The A-Flux (VahatiCor) is a novel CS reducer made of a dense nitinol mesh (Figure 1A) with four different sizes (Figure 1B) that enable implantation of the device in the specific CS segment where the greatest therapeutic benefit is expected. Additionally, the A-Flux is partially recapturable and repositionable. Its delivery system (Figure 1C) allows a low, chronic outward deployment force that anchors the device without the risk of balloon-induced CS dissection or rupture. Its dense nitinol mesh immediately diverts flow, resulting in double the mass flow through its central waist compared to a conventional open-cell stent design (Figure 1D). The A-Flux is preloaded into a 10 Fr delivery system; however, its distal tapered nose cone achieves...