A system includes a stent positionable within a coronary vein. The stent includes a valve and a stent body coupled to the valve and arranged to transition between a collapsed state and an expanded state. The system includes an intravascular reperfusion therapy device with a sensor and a catheter with a lumen shaped to receive the stent. The intravascular reperfusion therapy device delivers reperfusion therapy to a myocardium of a heart. The system includes a processor circuit that receives physiological data from the sensor, determines a progression of the reperfusion therapy, controls a configuration of the valve and/or the expansion state of the stent such that back pressure is controlled. With the stent in the expanded state, the stent body contacts a wall of the coronary vein and the valve obstructs blood flow in a first direction to generate the back pressure in an opposite, second direction.