Treatment of Refractory No-Reflow in Cardiac Catheterization Laboratory; Role of Intracoronary Verapamil (A Case Report)

The no reflow phenomenon is a feared complication in Percutaneous Coronary Intervention (PCI) procedures including elective as well primary PCI (Percutaneous Intervention), and results worse prognosis. A number of etiological factors are involved pathogenesis phenomenon. These include distal athero embolization, ischemic reperfusion injury, microvascular spasm endothelial dysfunction. treatment depends on underlying mechanism includes pharmacological non-pharmacological interventions. Pharmacological agents vasodilators like adenosine, sodium nitroprusside, verapamil, addition to adrenaline (intracoronary) and, GpIIa/IIIb inhibitors. Non measures mechanical thrombus aspiration. Among agents, Verapamil usually the least preferred agent because its negative ionotropic effect. Here, we describe case refractory patient undergoing right coronary artery (RCA), which was treated with no. aspiration thrombectomy but without much success finally responded intracoronary verapamil.