No-Reflow Phenomenon: A Major Issue Concerning Revascularization in Acute Coronary Syndromes

Authors

  • Dimitrios Ikonomou Evagelismos Hospital, Athens, Greece
  • Dimitra Benia Evagelismos Hospital, Athens, Greece
  • Antigoni Kyparissi Evagelismos Hospital, Athens, Greece
  • Georgios Ferentinos Evagelismos Hospital, Athens
  • Konstantinos Triantafyllou Evagelismos Hospital, Athens

Keywords:

no-reflow, revascularization, acute coronary syndromes

Abstract

The no-reflow phenomenon (NRp), a dreaded complication of primary and also of any complex percutaneous coronary intervention (PCI), is characterized by insufficient myocardial perfusion in a territory of a coronary artery without evidence of mechanical obstruction. Microvascular injury is the underlying mechanism of NRp and its manifestation is not only impaired TIMI flow (<3), but also impaired TIMI myocardial perfusion grade (TMPG) which should be assessed in case of chest pain, persistent ST segment elevation or hemodynamic compromise despite the presence of TIMI III flow. The NRp mechanism is multifaceted, the evidence base for its treatment is inconsistent and limited, but its predictors are well known. The armamentarium against NRp consists of preventive and therapeutic strategies, both mechanical and pharmacological. A brief overview of all the above issues concerning NRp is attempted herein. Rhythmos 2019;14(2):27-30.

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Published

2019-04-26

Issue

Vol. 14 No. 2 (2019)

Section

Review

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