Effect of Intracoronary Nicorandil Administration on Preventing No-Reflow/Slow Flow Phenomenon During Rotational Atherectomy

Increase in serum troponin-I following rotational atherectomy reliably predicts the occurrence of reversible wall motion abnormalities

“…To date, prophylaxis and management of the rotational atherectomy-related complications remain poorly developed. Despite the use of calcium antagonists [4], ATP [26], and nicorandil [27], in the present study, no-reflow still occurs on occasion. Further refinements in equipment, technique, and pharmacologic supports are necessary to decrease the incidence of complications.…”

2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention

“…676,678,679,681,684,686,689,691 There are fewer data to support the use of epinephrine. 692 No-reflow after rotational atherectomy was less common with nicorandil compared with verapamil infusions in 3 studies, [693][694][695] and an infusion of nicorandil/adenosine during rotational atherectomy prevented no-reflow in 98% of patients. 677 Trials of pre-PCI intracoronary verapamil, nicardipine, and adenosine have reported them to be safe but have not demonstrated reductions in post-PCI no-reflow.…”

Myocardial Protective Effects of Nicorandil During Percutaneous Coronary Intervention in Patients With Unstable Angina

“…10 Another study of patients with myocardial infarction who had PCI reported that those who had an injection of nicorandil showed significant improvement in LV function, wall motion score index and regional wall motion, as well as less frequent complications in hospital and less frequent no-reflow phenomenon on contrast echocardiography. 11,[31][32][33] Investigations of the myocardial protective effect of nicorandil during PCI reported that STsegment sum and QT dispersion during PCI decreased in chronic stable angina patients after oral nicorandil was administered for 1 week. 12, 34 Ikeda et al compared the degree of ST-segment elevation in acute myocardial infarction patients who required primary coronary artery intervention in those injected with nicorandil and those with isosorbide dinitrate.…”