No-Reflow Phenomenon

Author:

Galasso Gennaro1,Schiekofer Stephan2,D’Anna Carolina1,Gioia Giuseppe Di1,Piccolo Raffaele1,Niglio Tullio1,Rosa Roberta De1,Strisciuglio Teresa1,Cirillo Plinio1,Piscione Federico3,Trimarco Bruno1

Affiliation:

1. Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II University, Naples, Italy

2. Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA

3. Department of Medicine and Surgery, University of Salerno, Salerno, Italy

Abstract

No-reflow is responsible for 40% of the primary percutaneous coronary intervention without complete myocardial reperfusion despite successful reopening of the infarct-related artery. This review describes the main pathophysiological mechanisms of no-reflow, its clinical manifestation, including the strong association with increased in-hospital mortality, malignant arrhythmias, and cardiac failure as well as the diagnostic methods. The latter ranges from simple angiographic thrombolysis in myocardial infarction grade score to more complex angiographic indexes, imaging techniques such as myocardial contrast echo or cardiac magnetic resonance, and surrogate clinical end points such as ST-segment resolution. This review also summarizes the strategies of prevention and treatment of no-reflow, considering the most recent studies results regarding medical therapy and devices.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine

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