This case report illustrates a refractory case of coronary no-reflow phenomenon during PCI for acute myocardial infarction that did not resolve with standard intracoronary vasodilator therapy.
Case report of no-reflow in AMI; leaves open optimal microvasculature-targeted strategies in PCI.
Coronary no-reflow phenomenon is a disorder of the microvasculature that results in poor myocardial perfusion in patients with acute myocardial infarction receiving percutaneous coronary intervention. It typically manifests as TIMI 1-2 flow, high TIMI frame counts, and abnormal myocardial blush. The etiology of this condition is multifactorial and so is its treatment. It is encountered in approximately one-third of patients and is therefore of clinical relevance. In this case report, we describe a patient scenario with this condition in which the standard therapy was provided but failed to achieve normal perfusion despite repeat attempts. We also discuss different pharmacological therapies that compose the standard therapy and other adjunctive remedies that have been proven to be beneficial.
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Karimianpour et al. (2017) studied this question.
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