The no-reflow phenomenon has been recognized as an uncommon complication after reperfusion therapy (thrombolytic or mechanical) for acute myocardial infarction and after percutaneous coronary intervention. As management and outcomes differ, early diagnosis and angiographic exclusion of other causes of impaired blood flow are important. The authors describe a case report of a patient with no-reflow following emergent stenting of the left circumflex artery (LCX). Pathophysiology and management of the no-reflow phenomenon are described along with the case report.
Get full access to this article
View all access options for this article.
References
1.
Kloner RA, Ganote CE, Jennings RB: The "no-reflow" phenomenon after temporary coronary occlusion in the dog. J Clin Invest54:1496-1508, 1974 .
2.
Abbo KM, Dooris M., Glazier S., et al: Features and outcome of no-reflow after percutaneous coronary intervention. Am J Cardiol75:778-782, 1995.
3.
Piana RN, Paik GY, Moscucci M., et al: Incidence and treatment of 'no-reflow' after percutaneous coronary intervention. Circulation89:2514-2518, 1994.
4.
Weyrens FJ, Mooney J., Lesser J., et al: Intracoronary diltiazem for microvascular spasm after interventional therapy. Am J Cardiol75:849-850, 1995.
5.
Przyklenk K. , Kloner RA: "Reperfusion injury" by oxygen-derived free radicals? Effect of superoxide dismutase + catalase, given at the time of reperfusion, on myocardial infarct size, contractile function, coronary microvasculature and regional blood flowCirc Res64:86-96, 1989.
6.
Mueller HS, Rao PS, Greenberg MA, et al: Systemic and transcardiac platelet activity in acute myocardial infarction in man: Resistance to prostacyclin. Circulation72:1336-1345, 1985.
7.
Kloner RA, Rude RE, Carlson N., et al: Ultrastructural evidence of microvascular damage and myocardial cell injury after coronary artery occlusion: Which comes first? Circulation62:945-952, 1980.
8.
Kloner RA: No reflow visited. Editorial commentJ Am Coll Cardiol14:1814-1815, 1989.
9.
The EPIC Investigators: Use of monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptors in high-risk coronary angioplasty. N Engl J Med330:956-961, 1994.
10.
The EPILOG Investigators: Platelet glycoprotein IIb/IIIa receptor blockade and low-dose heparin during percutaneous coronary revascularizations . N Engl J Med336:1689-1696, 1997 .
