Impervious Coronary No-Reflow: A Case Study

Abstract

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.

An unusual no‐reflow phenomenon due to neointimal tissue embolization during drug eluting balloon intervention in stent restenosis: A case report

“…However, despite these technical improvements, no‐reflow phenomenon is still a challenging complication during PCI 3,4 . Previous studies have shown that no‐reflow phenomenon is identified in approximately 2% of patients undergoing PCI 4–6 . The hypotheses and mechanisms of no‐reflow phenomenon are multifactorial, including micro‐embolization, coronary dissection, microvascular dysfunction, reperfusion injury, and vasospasm 7–9 .…”

“…3,4 Previous studies have shown that no-reflow phenomenon is identified in approximately 2% of patients undergoing PCI. [4][5][6] The hypotheses and mechanisms of no-reflow phenomenon are multifactorial, including micro-embolization, coronary dissection, microvascular dysfunction, reperfusion injury, and vasospasm. [7][8][9] However, there are still no definitive hypotheses and mechanisms for the no-reflow phenomenon and it remains a subject of controversy.…”