Does abciximab improve distal runoff in patients with no-reflow phenomenon following catheter interventions?
Abciximab may rapidly reverse the no-reflow phenomenon following coronary interventions, suggesting a role for platelet-mediated mechanisms in this condition.
The no-reflow phenomenon is a reduction in epicardial coronary artery blood flow without mechanical vessel obstruction. Early descriptions of this syndrome involved reperfusion after myocardial infarction. More recently, the no-reflow phenomenon has been recognized after brief ischemic times associated with coronary interventions. It is clearly a negative prognostic indicator. The proposed mechanism is multi-factorial and may involve small vessel vasospasm and potentially platelet-mediated loss of capillary autoregulation. Because of the potential role of platelets in the genesis of the no-reflow state, we administered Abciximab to two patients with no-reflow phenomenon following catheter interventions. In both of these settings, rapid distal runoff was reestablished within minutes after treatment with the platelet glycoprotein 2B/3A inhibitor.
Rawitscher et al. (Wed,) studied this question.