No-reflow is an unpredictable complication following percutaneous coronary intervention. No- reflow is associated with myocardial ischemia and infarction and increased mortality. A case of refractory no-reflow is described that was rapidly and successfully treated with multiple infusions of high doses of verapamil and adenosine applied directly at the site of no-reflow through a perfusion catheter.
Get full access to this article
View all access options for this article.
References
1.
Piana RN, Paik GY, Moscucci M., et al: Incidence and treatment of 'no-reflow' after percutaneous coronary intervention. Circulation89:2514-2518, 1994.
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.
Seydoux C., Goy J., Graham D.: Platelet and neutrophil imaging techniques in the investigation of the response to thrombolytic therapy and the no-reflow phenomenon. Am Heart J125:1142-1147, 1993.
4.
The GUSTO Angiographic Investigators: The effects of tissue plasminogen activator, streptokinase, or both on coronary artery patency, ventricular function, and survival after acute myocardial infarction. N Engl J Med329:1615-1622, 1993.
5.
Wilson RF, Laxson DD, Lesser JR, et al: Intense microvascular constriction after angioplasty of acute thrombotic coronary arterial lesions. Lanceti (8642):807-811,1989.
6.
Rawitscher D. , Levin TN, Cohen I., et al: Rapid reversal of no-reflow using abciximab after coronary device intervention. Cathet Cardiovasc Diagn42:187-190, 1997.
7.
Fischell TA, Carter AJ, Foster MT, et al: Reversal of "no reflow" during vein graft stenting using high velocity boluses of intracoronary adenosine. Cathet Cardiovasc Diagn45:360-365, 1998.
8.
Piana RN, Paik GY, Moscucci M., et al: Incidence and treatment of 'no-reflow' after percutaneous coronary intervention. Circulation89:2514-2518, 1994.
9.
Wilson RF, Wyche K., Christensen BV, et al: Effects of adenosine on human coronary arterial circulation . Circulation82:1595-1605, 1990 .
10.
Fischell TA , Carter AJ, Foster MT, et al: Reversal of "no reflow" during vein graft stenting using high velocity boluses of intracoronary adenosine. Cathet Cardiovasc Diagn45:360-365, 1998.
