This review summarizes the pathophysiological mechanisms, clinical manifestations, diagnostic methods, and prevention and treatment strategies for the no-reflow phenomenon in primary PCI.
This review summarizes the mechanisms, diagnosis, and management of the no-reflow phenomenon, which complicates up to 40% of primary PCIs without complete reperfusion.
No-reflow is responsible for 40% of the primary percutaneous coronary intervention without complete myocardial reperfusion despite successful reopening of the infarct-related artery. This review describes the main pathophysiological mechanisms of no-reflow, its clinical manifestation, including the strong association with increased in-hospital mortality, malignant arrhythmias, and cardiac failure as well as the diagnostic methods. The latter ranges from simple angiographic thrombolysis in myocardial infarction grade score to more complex angiographic indexes, imaging techniques such as myocardial contrast echo or cardiac magnetic resonance, and surrogate clinical end points such as ST-segment resolution. This review also summarizes the strategies of prevention and treatment of no-reflow, considering the most recent studies results regarding medical therapy and devices.
Galasso et al. (Tue,) conducted a review in No-reflow phenomenon in primary percutaneous coronary intervention. Prevention and treatment strategies for no-reflow was evaluated. This review summarizes the pathophysiological mechanisms, clinical manifestations, diagnostic methods, and prevention and treatment strategies for the no-reflow phenomenon in primary PCI.