Management of No-Reflow Phenomenon in the Catheterization Laboratory

Abstract At the conclusion of a primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, and after the cardiologist makes certain that there is no residual stenosis following stenting, assessment of coronary flow becomes the top priority. The presence of no-reflow i...

Full description

Saved in:
Bibliographic Details
Published in:JACC. Cardiovascular interventions 2017-02, Vol.10 (3), p.215-223
Main Authors: Rezkalla, Shereif H., MD, Stankowski, Rachel V., PhD, Hanna, Jennifer, MD, Kloner, Robert A., MD, PhD
Format: Article
Language:English
Subjects:
Angioplasty, Balloon, Coronary - adverse effects
Animals
Cardiac Catheterization - adverse effects
Cardiovascular
Coronary Circulation - drug effects
Humans
no-reflow
No-Reflow Phenomenon - diagnosis
No-Reflow Phenomenon - etiology
No-Reflow Phenomenon - physiopathology
No-Reflow Phenomenon - therapy
percutaneous coronary intervention
Predictive Value of Tests
Risk Factors
ST Elevation Myocardial Infarction - diagnosis
ST Elevation Myocardial Infarction - physiopathology
ST Elevation Myocardial Infarction - therapy
ST-segment elevation myocardial infarction
Treatment Outcome
Vasodilator Agents - therapeutic use
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract At the conclusion of a primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, and after the cardiologist makes certain that there is no residual stenosis following stenting, assessment of coronary flow becomes the top priority. The presence of no-reflow is a serious prognostic sign. No-reflow can result in poor healing of the infarct and adverse left ventricular remodeling, increasing the risk for major adverse cardiac events, including congestive heart failure and death. To achieve normal flow, features associated with a high incidence of no-reflow must be anticipated, and measures must be undertaken to prevent its occurrence. In this review, the authors discuss various preventive strategies for no-reflow as well as pharmacological and nonpharmacological interventions that improve coronary blood flow, such as intracoronary adenosine and nitroprusside. Nonpharmacological therapies, such as induced hypothermia, were successful in animal studies, but their effectiveness in reducing no-reflow in humans remains to be determined.
ISSN:1936-8798
1876-7605
DOI:10.1016/j.jcin.2016.11.059