Intracoronary Injection of Drugs to Treat No – Reflow Phenomenon and Microcirculatory Dysfunction
Andrea Rognoni, Alessandro Lupi, Chiara Cavallino, Gioel Gabrio Secco, Roberta Rosso and Angelo Sante Bongo
Affiliation: Coronary Care Unit and Catheterization Laboratory, Hospital “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy.
In a variant proportion of patients presenting with chest pain and electrocardiographic changes characteristic
for ST – elevation myocardial infarction, percutaneous coronary intervention achieves epicardial coronary artery
reperfusion but not the myocardial reperfusion (ranging from 5% to 50%). Furthermore, prolonged myocardial ischemia
often breaks down the coronary microvasculature and the flow to the infarct myocardium may seem to be markedly
reduced. This condition is known as no reflow – phenomenon. The no reflow - phenomenon is associated with an
increased incidence of malignant ventricular arrhythmias, heart failure and 30-days mortality. In the recent years in
literature, several articles (subsequently discussed in the present review) have been published and made relevant to the
study of the pathophysiology regarding no reflow – phenomenon. This knowledge has assisted in the development of new
treatment strategies, such as prophylactic use of vasodilators, mechanical devices and drugs inhibiting platelet.
The review has focused on the current literature about intra – coronary injection of drugs to treat no – reflow and
Keywords: No – reflow phenomenon, microcirculatory dysfunction, acute myocardial infarction, primary coronary intervention,
percutaneous coronary intervention, microcirculatory dysfunction, intracoronary drug, vascular resistance, thrombus, distal
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