Management of No-Reflow Phenomenon in the Catheterization Laboratory

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Management of the no-reflow phenomenon.

The lack of reperfusion of myocardium after prolonged ischaemia that may occur despite opening of the infarct-related artery is termed "no reflow". No reflow or slow flow occurs in 3-4% of all percutaneous coronary interventions, and is most common after emergency revascularization for acute myocardial infarction. In this setting no reflow is reported to occur in 30% to 40% of interventions whe...

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Society of cardiac angiography and interventions: suggested management of the no-reflow phenomenon in the cardiac catheterization laboratory.

The interventional cardiologist makes a provisional diagnosis of the no-reflow phenomenon in the presence of an acute reduction in coronary flow despite a widely patent epicardial vessel during percutaneous coronary intervention (PCI). Its occurrence is recognized as a column of contrast arising distal to the original target stenosis that does not rapidly clear [1–3]. The precise pathophysiolog...

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Treating and Preventing No Reflow in the Cardiac Catheterization Laboratory

The no reflow phenomenon can happen during elective or primary percutaneous coronary intervention. This phenomenon is thought to be a complex process involving multiple factors that eventually lead to microvascular obstruction and endothelial disruption. Key pathogenic components include distal atherothrombotic embolization, ischemic injury, reperfusion injury, and susceptibility of coronary mi...

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No-reflow phenomenon.

To the Editor: In reviewing no-reflow, Rezkalla and Kloner1 indicted injuryinduced microvascular changes, but did not mention spasm of resistance vessels, which might be the basic mechanism of no-reflow. I proposed in 1971 that no-reflow (“stasis”) is due to ischemic injury-induced spasm, and the evidence seemed convincing.2 Short coronary occlusions reversed no-reflow, and this was interpreted...

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'No-reflow' phenomenon.

A 57-year-old man presented with new anginal symptoms nine years after three-vessel coronary artery bypass grafting. Cardiac catherization revealed severely and diffusely diseased saphenous vein graft to the obtuse marginal coronary artery. Percutaneous coronary intervention was complicated by the ‘no-reflow’ phenomenon. The patient suffered a periprocedural myocardial infarction (peak troponin...

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ژورنال

عنوان ژورنال: JACC: Cardiovascular Interventions

سال: 2017

ISSN: 1936-8798

DOI: 10.1016/j.jcin.2016.11.059