Complications of coronary intervention: device embolisation, no-reflow, air embolism

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Incidence and treatment of 'no-reflow' after percutaneous coronary intervention.

BACKGROUND Profound reduction in antegrade epicardial coronary flow with concomitant ischemia is seen occasionally during percutaneous coronary intervention despite the absence of evident vessel dissection, obstruction, or distal vessel embolic cutoff. In a prior small series of cases, this "no-reflow" phenomenon appeared to be promptly reversed by the intra-coronary administration of verapamil...

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Predicting the no-reflow phenomenon following successful percutaneous coronary intervention.

In the setting of acute myocardial infarction, early and adequate reopening of an infarct-related artery is not necessarily followed by a complete restoration of myocardial perfusion. This condition is usually defined as 'no-reflow'. The pathophysiology of no-reflow is multifactorial since extravascular compression, microvascular vasoconstriction, embolization during percutaneous coronary inter...

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Primary percutaneous coronary intervention: devices to prevent no-reflow phenomenon

Primary percutaneous coronary intervention, where available, has become the therapy of choice in myocardial reperfusion during ST-elevation myocardial infarction. However, in a significant proportion of patients, owing to a high thrombus burden, myocardial perfusion is not fully achieved in the epicardial vessel. This phenomenon has been attributed predominantly to the distal embolization of th...

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Coronary air embolism.

The case report of acute coronary episode caused by air embolism associated with the removal of central vascular access, published in "Anaesthesiology Intensive Therapy"1/2012 aroused much interest [1]. Iatrogenic gas emboli are rare, albeit dramatic complications of therapeutic interventions,which result in persistent neurological symptoms in over 40% of cases [2].

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The role of vasodilators in the prevention and treatment of no-reflow following percutaneous coronary intervention.

The routine use of vasodilators in patients with acute coronary syndromes or other groups undergoing percutaneous coronary intervention (PCI) cannot be recommended at present. However, in the event of no-reflow occurring following PCI, intracoronary adenosine or verapamil should be administered.

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ژورنال

عنوان ژورنال: Heart Asia

سال: 2013

ISSN: 1759-1104

DOI: 10.1136/heartasia-2013-010303