A system includes an intravascular reperfusion therapy device positionable within a coronary vein to deliver reperfusion therapy to a myocardium of a heart. The intravascular reperfusion therapy device includes a catheter and a sensor. The catheter includes a plurality of arms configured to expand into the coronary vein to deliver the reperfusion therapy by obstructing blood flow in a first direction to generate back pressure in an opposite, second direction. The system includes a processor circuit that receives, from the sensor, physiological data associated with blood flow, determines, based on the physiological data, a progression of the reperfusion therapy, and controls, based on the progression of the reperfusion therapy, expansion of the plurality of arms while the intravascular reperfusion therapy device is positioned within the coronary vein such that the back pressure within the coronary vein is controlled.