Myocardial No-Reflow Treatment

Olivier      Muller; Catalina      Trana; Eric      Eeckhout

Abstract

No-reflow phenomenon is a consequence of percutaneous coronary intervention (PCI) which arises most of the time in the setting of myocardial infarction, but can be also the consequence of PCI in stable angina patients (rotatablator ablation technique or angioplasty in saphenous vein grafts). In this review, we summarize two ways of treating the noreflow according to the current literature. First through the pharmacological approach where several compounds have been assessed like adenosine, nitruprusside, verapamil, nicorandil, dipyridamole, epinephrine or cyclosporine. Second through the mechanical approach where few strategies have been examined like intra-aortic ballon pumping or postconditioning. Finally, we provide an algorithm for treating a no-reflow even though no studies showed a beneficial effect in terms of clinical endpoints.

Keywords: No-reflow, slow-flow, myocardial infarction, reperfusion

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