The no-reflow phenomenon: mechanisms and therapeutic targets

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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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No-reflow phenomenon.

Because total coronary artery occlusion was found in the early hours of transmural myocardial infarction, most of our research interest and treatment strategies focus on epicardial coronary arteries.1 Little attention, however, is paid to the coronary microvasculature. When a coronary artery is occluded, detrimental changes occur in the cardiac capillaries and arterioles. After relief of the oc...

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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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The coronary no-reflow phenomenon: a review of mechanisms and therapies.

The phenomenon of no-reflow is defined as inadequate myocardial perfusion through a given segment of the coronary circulation without angiographic evidence of mechanical vessel obstruction. Temporary occlusion of the artery, a prerequisite condition for no-reflow, may be produced in the experimental setting or occur during reperfusion of an infarct-related artery or following percutaneous coron...

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ژورنال

عنوان ژورنال: Regional blood circulation and microcirculation

سال: 2018

ISSN: 1682-6655

DOI: 10.24884/1682-6655-2018-17-1-5-12