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This autologous cell-based therapy involves the use of **bone marrow aspirate concentrate (BMAC)** in combination with **transmyocardial revascularization (TMR)** for the treatment of refractory angina pectoris. The procedure utilizes the **PHOENIX Combination Delivery System**, which employs a Holmium:YAG laser to create channels in the ischemic myocardium (TMR) while simultaneously injecting concentrated autologous bone marrow-derived stem cells directly into the heart tissue. The therapy is designed for patients with diffuse coronary artery disease who are not candidates for conventional revascularization procedures like CABG or PCI. The mechanism of action relies on the concentrated stem cells' ability to secrete angiogenic growth factors and the mechanical/thermal stimulus of the laser to promote neovascularization and improve myocardial perfusion. Developed by **Cardiogenesis Corporation** (a subsidiary of **Artivion**, formerly **CryoLife**), the PHOENIX system received CE Mark approval in 2006 but has not received FDA approval in the United States.
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