Devices and methods for reducing a size of a lumen are provided. In one embodiment, a lumen reduction device is provided having an end effector with a trough formed therein for receiving tissue surrounding a lumen, and a plurality of fasteners configured to engage the tissue disposed within the trough. In use, the end effector can be actuated to deliver the fasteners to the tissue, and one or more sutures coupled to the fasteners can be used to pull the fasteners together and thereby cinch the tissue to reduce the size of a lumen.