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 occlusion, blood flow to the ischemic tissue may still be impeded, a phenomenon known as no reflow. This article attempts to provide an in-depth understanding of this phenomenon from the laboratory bench to the clinical arena.