Coronary Microcirculation and the No-reflow Phenomenon

Author(s): Evangelos Oikonomou, Konstantinos Mourouzis, Georgia Vogiatzi, Gerasimos Siasos, Spyridon Deftereos, Spyridon Papaioannou, George Latsios, Sotiris Tsalamandris, Dimitris Tousoulis*.

Journal Name: Current Pharmaceutical Design

Volume 24 , Issue 25 , 2018


Abstract:

The no-reflow phenomenon refers to the post-percutaneous coronary intervention condition in which, despite re-establishing epicardial coronary vessel patency, the flow to the previously ischemic myocardium is markedly reduced. When it does occur, it attenuates the beneficial effect of reperfusion therapy and substantial regions of the myocardium fail to receive adequate perfusion. The pathophysiology of this phenomenon is not completely understood. The possible mechanisms could be related to alterations in the microvascular circulation. Various mechanisms such as activation of inflammatory pathways, vascular damage and hemorrhage, leukocyte infiltration, and cellular edema may be responsible. As the no-reflow phenomenon is associated with adverse clinical consequences, it is of great importance to identify exact responsible mechanisms and apply effective preventive and therapeutic strategies. In this review, we describe an updated overview of the pathophysiological mechanisms and the current preventive tools for no-reflow as well as therapeutic interventions in order to improve coronary blood flow and consequently the prognosis for these patients.

Keywords: Microcirculation, coronary arteries, coronary circulation, no-reflow, endothelial dysfunction, post-percutaneous coronary intervention.

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Article Details

VOLUME: 24
ISSUE: 25
Year: 2018
Page: [2934 - 2942]
Pages: 9
DOI: 10.2174/1381612824666180911122230
Price: $58

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