Society of cardiac angiography and interventions: Suggested management of the no‐reflow phenomenon in the cardiac catheterization laboratory

Klein, Lloyd W.; Kern, Morton J.; Berger, Peter B.; Sanborn, Timothy A.; Block, Peter C.; Babb, Joseph D.; Tommaso, Carl L.; Hodgson, John McB.; Feldman, Ted

doi:10.1002/ccd.10620

Cited by 54 publications

(59 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These high-risk patients should therefore be identified because they may benefit from adjunctive intracoronary therapies such as adenosine, verapamil, or nitroprusside. 24 …”

Section: Discussionmentioning

confidence: 99%

Coronary Blood Flow Assessment After Successful Angioplasty for Acute Myocardial Infarction Predicts the Risk of Long-Term Cardiac Events

et al. 2004

View full text Add to dashboard Cite

Background-Analysis of coronary flow velocity (CFV) in the recanalized infarct-related coronary artery (IRA) with a Doppler guidewire is useful for predicting recovery of regional left ventricular function, in-hospital complications, and survival. We postulated that the CFV pattern after IRA reperfusion for acute myocardial infarction (AMI) would predict long-term adverse cardiac events. Methods and Results-Sixty-eight consecutive patients with a first AMI underwent CFV measurement with a Doppler guidewire after successful reopening of the IRA by coronary angioplasty. At the end of follow-up, 3.8Ϯ1.7 years after AMI, 44 of the 65 surviving patients (67.7%) were free of long-term cardiac events. Univariate analysis showed that the following factors were predictive of an end point combining cardiac death, recurrent MI, and congestive heart failure: hypertension, age Ն65 years, time from onset of chest pain to PTCA Ն6 hours, peak creatine kinase Ͼ4000 IU/L, ejection fraction Յ50%, proximal left anterior descending artery occlusion, resting average peak velocity Յ10 cm/s, average systolic peak velocity Յ5 cm/s, a rapid diastolic deceleration time (Յ600 ms), and early retrograde systolic flow. In the final multivariate model, only age Ն65 years (OR, 3.6; 95% CI, 1.1 to 11.8; Pϭ0.03), time to PTCA Ն6 hours (OR, 2.9; 95% CI, 1.0 to 8.3; Pϭ0.04), and a rapid diastolic deceleration time (OR, 5.4; 95% CI, 1.5 to 19.3; Pϭ0.01) were independent predictors. Conclusions-The CFV pattern appears to be an accurate predictor of long-term cardiac events in patients having undergone successful reopening of the IRA after AMI, identifying a subset of at-risk patients.

show abstract

“…These high-risk patients should therefore be identified because they may benefit from adjunctive intracoronary therapies such as adenosine, verapamil, or nitroprusside. 24 …”

Section: Discussionmentioning

confidence: 99%

Coronary Blood Flow Assessment After Successful Angioplasty for Acute Myocardial Infarction Predicts the Risk of Long-Term Cardiac Events

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Vol 48 No 1 plaque in the lesions with slow flow and a side branch compromised after PCI were significantly lower compared to those in the lesions without the complication of PCI, and the CT density of plaque in the lesions with dissection and perforation after PCI was the highest (25.1 ± 41.8 HU, 257.1 ± 377.8 HU, and 712.1 ± 180.7 HU, P < 0.05).…”

mentioning

confidence: 87%

“…Despite its numerous benefits, serious and potentially life-threatening complications of PCI can occur, including slow flow phenomenon, 1,2) and coronary dissection and perforation. 3,4) PCI, which depends upon mechanical dilatation of the artery or ablation of atherosclerotic plaque, is requisitely associated with plaque rupture, 5,6) plaque fracture, intimal splitting, localized media dissection, and frank perforation.…”

mentioning

confidence: 99%

Coronary Arterial Plaque Characterized by Multislice Computed Tomography Predicts Complications Following Coronary Intervention

Kinohira

Akutsu

et al. 2007

Int. Heart J.

View full text Add to dashboard Cite

SUMMARYBackground: A reliable, noninvasive assessment of plaque configuration would constitute an important step forward for predicting complications following percutaneous coronary intervention (PCI). Multislice computed tomography (MSCT) holds promise with respect to allowing for differentiation of coronary lesion configuration. However, it has not yet been clarified whether the characteristics of coronary artery plaque measured by MSCT predict complications after PCI. The aim of this study was to investigate the relationship between plaque configuration and complications after coronary intervention in patients with stable angina pectoris.Methods: MSCT was performed in patients with angina pectoris who were scheduled for PCI prospectively, and 26 patients (70 ± 11 years, 18 males) with coronary artery plaque in a stenotic coronary artery measured by MSCT were recruited for this study. Thirty-five plaques in the stenotic coronary lesions were divided into 3 groups based on the CT density as soft, intermediate, and hard, and were compared with the complications after PCI. Results:The soft plaque group before PCI (n = 11) was significantly associated with the appearance of slow flow (n = 4) or a compromised side branch (n = 1) after PCI, whereas the hard plaque group before PCI (n = 17) was associated with the appearance of dissection (n = 2) or perforation (n = 1) after PCI (P = 0.004). The intermediate plaque group (n = 7) had only one complication, a compromised side branch (n = 1). Conclusion:Coronary arterial plaque characterized by MSCT can predict interventionrelated complication. It may be important for the risk stratification of the patients scheduled to undergo PCI to investigate plaque configuration by MSCT.(Int Heart J 2007; 48: [25][26][27][28][29][30][31][32][33]

show abstract

“…Drug treatment aimed at reducing the no-reflow phenomenon may improve myocardial salvage, thus preventing left ventricular remodeling [2,3,4,5,6]. Various treatment strategies have been associated with an improvement in angiographic flow in several studies, but whether these treatment strategies affect clinical outcome is not clear [2,3,4,6].…”

Section: Introductionmentioning

confidence: 99%

“…Diagnostic techniques to measure tissue perfusion have validated this concept in humans and it is now clear that abnormal tissue perfusion occurs frequently in STEMI patients undergoing primary percutaneous coronary intervention (PCI). The presence of no-reflow during PCI has been associated with worsened short- and long-term outcomes, the risk of subsequent major adverse events and negative remodeling [1,2,3,4,5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

Effect of New Method of Intracoronary Adenosine Injection during Primary Percutaneous Coronary Intervention on Microvascular Reperfusion Injury - Clinical Outcome and 1-Year Follow-Up

Grygier¹,

Araszkiewicz²,

Lesiak³

et al. 2013

Cardiology

View full text Add to dashboard Cite

Objectives: The aim of this single-center, randomized placebo-controlled trial in 70 consecutive patients (64 ± 14 years) with acute myocardial infarction was to examine the role of a new protocol of adenosine administration during primary angioplasty on immediate electrocardiographic and angiographic results, clinical outcome and 1-year follow-up. Methods: Group A (n = 35) twice received intracoronary adenosine through the guiding catheter: immediately after crossing the lesion of the infarct-related artery with guidewire and then after first balloon inflation. Group B (n = 35) received placebo. Results: Resolution of ST segment elevation was more frequently observed in the adenosine than in the placebo group (p < 0.01). Percutaneous coronary intervention (PCI) resulted in borderline better TIMI 3 flow after the procedure in the adenosine group than in the placebo group. Myocardial blush grade 3 at the end of the procedure was significantly improved in the adenosine compared to the placebo group (p < 0.05). At 1-year the composite end-point of death, recurrent myocardial infarction, heart failure and clinically driven target vessel revascularization was present in 8 patients in the adenosine group and 16 patients in placebo group (p < 0.05). Conclusions: Intracoronary adenosine improved electrocardiographic and angiographic results in patients undergoing primary PCI and seemed to be associated with more favorable clinical course.

show abstract

Society of cardiac angiography and interventions: Suggested management of the no‐reflow phenomenon in the cardiac catheterization laboratory

Cited by 54 publications

References 60 publications

Coronary Blood Flow Assessment After Successful Angioplasty for Acute Myocardial Infarction Predicts the Risk of Long-Term Cardiac Events

Coronary Blood Flow Assessment After Successful Angioplasty for Acute Myocardial Infarction Predicts the Risk of Long-Term Cardiac Events

Coronary Arterial Plaque Characterized by Multislice Computed Tomography Predicts Complications Following Coronary Intervention

Effect of New Method of Intracoronary Adenosine Injection during Primary Percutaneous Coronary Intervention on Microvascular Reperfusion Injury - Clinical Outcome and 1-Year Follow-Up

Contact Info

Product

Resources

About