# The Beck Procedure Revisited: Percutaneous Approach to Myocardial Perfusion Through the Coronary Sinus

## TL;DR

A new percutaneous procedure using a noncovered stent to improve heart blood flow in patients with persistent angina is shown to be safe and effective.

## Contribution

A novel, reproducible percutaneous method using a noncovered stent to connect the LCX and coronary sinus is introduced.

## Key findings

- The procedure successfully relieved angina without causing bleeding.
- The method is shown to be widely applicable and safe for patients with lifestyle-limiting angina.
- Using a noncovered stent between the LCX and coronary sinus is feasible for myocardial perfusion.

## Abstract

Many patients live with angina following treatment when all available therapies have failed. Providing retrograde arterial myocardial perfusion using the coronary venous system was performed. The first previously reported percutaneous method might have limited application.

We present a first-in-human successful, reproducible, and widely applicable percutaneous procedure using a noncovered coronary stent to connect the left circumflex (LCX) to the coronary sinus (CS) in a patient with previous placement of a CS Reducer.

Unlike the previous report, our procedure shows for the first time that placement of a noncovered stent between the proximal LCX and the CS did not result in bleeding while effectively relieving the angina. Using a noncovered stent to create a bypass to the CS makes the procedure applicable to more patients with lifestyle-limiting angina.

Using the noncovered stent from the LCX to the CS to provide myocardial perfusion might be feasible and safe.