Case Report A Practical Method for No-Reflow Treatment

No-reflow is an undesirable result of percutaneous coronary interventions (PCI) [1]. Intracoronary (IC) vasodilators such as verapamil, nitroprusside, or adenosine are being administered for the treatment of no-reflow via the guiding catheter [2], but sometimes distal flow restoration is not satisfactory especially in patients with TIMI 0 flow. Vasoactive drug administration at the distal part of the coronary artery is suggested as a treatment option for no-reflow and some distal infusion catheters [3] and over-the-wire (OTW) balloon catheters [4] are being used for this purpose. However, OTW catheters need long guide wires and changing a short wire with a long wire has the risk of wire loss. Distal infusion catheters are special catheters for drug infusion at various vascular sites, but these catheters are not always available. Monorail balloon catheters are themostwidely used catheters in routine clinical practice. Here, we describe two cases of successful no-reflow management by previously used monorail balloon at the same procedure as a hand-made distal infusion catheter.