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Advances in Coronary No-Reflow Phenomenon—a Contemporary Review

  • Women and Ischemic Heart Disease (A. Maran, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Coronary artery no-reflow phenomenon is an incidental outcome of percutaneous coronary intervention in patients presenting with acute myocardial infarction. Despite advances in pharmacologic and non-pharmacologic therapies, coronary no-reflow phenomenon occurs more commonly than desired. It often results in poor clinical outcomes and remains as a relevant consideration in the cardiac catheterization laboratory. In this systematic review, we have sought to discuss the topic in detail, and to relay the most recent discoveries and data on management of this condition.

Recent Findings

We discuss several pharmacologic and non-pharmacologic treatments used in the prevention and management of coronary no-reflow and microvascular obstruction. Covered topics include the understanding of pharmacologic mechanisms of current and future agents, and recent discoveries that may result in the development of future treatment options.

Summary

We conclude that the pathophysiology of coronary no-reflow phenomenon and microvascular obstruction still remains incompletely understood, although several plausible theories have led to the current standard of care for its management. We also conclude that coronary no-reflow phenomenon and microvascular obstruction must be recognized as a multifactorial condition that has certain predispositions and characteristics, therefore its prevention and treatment must begin pre-procedurally and be multi-faceted including certain medications and operator techniques in the cardiac catheterization laboratory.

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Authors and Affiliations

  1. Department of Cardiovascular Diseases, Heart & Vascular Institute, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC, 29425, USA

    Ahmadreza Karimianpour & Anbukarasi Maran

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  1. Ahmadreza Karimianpour
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Correspondence to Ahmadreza Karimianpour.

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Ahmadreza Karimianpour and Anbukarasi Maran declare no conflict of interest.

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This article is part of the Topical Collection on Women and Ischemic Heart Disease

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Karimianpour, A., Maran, A. Advances in Coronary No-Reflow Phenomenon—a Contemporary Review. Curr Atheroscler Rep 20, 44 (2018). https://doi.org/10.1007/s11883-018-0747-5

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