Prevention and treatment of no-reflow phenomenon by targeting the coronary microcirculation

Attila Feher, Stephen Y. Chen, Zsolt Bagi, Vishal Arora

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

The coronary no-reflow phenomenon refers to the post-percutaneous coronary intervention (PCI) state in which, despite successful revascularization of the epicardial conduit coronary arteries, substantial regions of the myocardium do not receive adequate perfusion. In most cases, the underlying mechanism can be attributed to alterations in the microvascular circulation caused by factors intrinsic or extrinsic to the coronary microcirculation. Because the no-reflow phenomenon is associated with poor clinical outcomes, it is of great importantance to identify and apply effective strategies for reducing post-PCI morbidity and mortality. Successful prevention strategies aim to ad dress increased vasoreactivity, intravascular platelet aggregation, microvascular inflammation, and down-stream plaque particle embolization. This review provides an updated overview on the pathomechanism of no-reflow and the current available prevention strategies from the perspective of coronary microcirculation. Although large randomized clinical trials have not yet identified any effective treatment, studying the coronary microcirculation may reveal new therapeutic targets for successful amelioration of the adverse clinical consequences from no-reflow phenomenon.

Original languageEnglish (US)
Pages (from-to)38-51
Number of pages14
JournalReviews in Cardiovascular Medicine
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2014

Fingerprint

No-Reflow Phenomenon
Microcirculation
Percutaneous Coronary Intervention
Intrinsic Factor
Platelet Aggregation
Coronary Vessels
Myocardium
Randomized Controlled Trials
Perfusion
Inflammation
Morbidity
Mortality
Therapeutics

Keywords

  • Coronary microcirculation
  • Microvascular obstruction
  • No-reflow

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

Prevention and treatment of no-reflow phenomenon by targeting the coronary microcirculation. / Feher, Attila; Chen, Stephen Y.; Bagi, Zsolt; Arora, Vishal.

In: Reviews in Cardiovascular Medicine, Vol. 15, No. 1, 01.01.2014, p. 38-51.

Research output: Contribution to journalReview article

@article{ee433711b2b943c79be0128a80781793,
title = "Prevention and treatment of no-reflow phenomenon by targeting the coronary microcirculation",
abstract = "The coronary no-reflow phenomenon refers to the post-percutaneous coronary intervention (PCI) state in which, despite successful revascularization of the epicardial conduit coronary arteries, substantial regions of the myocardium do not receive adequate perfusion. In most cases, the underlying mechanism can be attributed to alterations in the microvascular circulation caused by factors intrinsic or extrinsic to the coronary microcirculation. Because the no-reflow phenomenon is associated with poor clinical outcomes, it is of great importantance to identify and apply effective strategies for reducing post-PCI morbidity and mortality. Successful prevention strategies aim to ad dress increased vasoreactivity, intravascular platelet aggregation, microvascular inflammation, and down-stream plaque particle embolization. This review provides an updated overview on the pathomechanism of no-reflow and the current available prevention strategies from the perspective of coronary microcirculation. Although large randomized clinical trials have not yet identified any effective treatment, studying the coronary microcirculation may reveal new therapeutic targets for successful amelioration of the adverse clinical consequences from no-reflow phenomenon.",
keywords = "Coronary microcirculation, Microvascular obstruction, No-reflow",
author = "Attila Feher and Chen, {Stephen Y.} and Zsolt Bagi and Vishal Arora",
year = "2014",
month = "1",
day = "1",
doi = "10.3909/ricm0699",
language = "English (US)",
volume = "15",
pages = "38--51",
journal = "Reviews in Cardiovascular Medicine",
issn = "1530-6550",
publisher = "MedReviews LLC",
number = "1",

}

TY - JOUR

T1 - Prevention and treatment of no-reflow phenomenon by targeting the coronary microcirculation

AU - Feher, Attila

AU - Chen, Stephen Y.

AU - Bagi, Zsolt

AU - Arora, Vishal

PY - 2014/1/1

Y1 - 2014/1/1

N2 - The coronary no-reflow phenomenon refers to the post-percutaneous coronary intervention (PCI) state in which, despite successful revascularization of the epicardial conduit coronary arteries, substantial regions of the myocardium do not receive adequate perfusion. In most cases, the underlying mechanism can be attributed to alterations in the microvascular circulation caused by factors intrinsic or extrinsic to the coronary microcirculation. Because the no-reflow phenomenon is associated with poor clinical outcomes, it is of great importantance to identify and apply effective strategies for reducing post-PCI morbidity and mortality. Successful prevention strategies aim to ad dress increased vasoreactivity, intravascular platelet aggregation, microvascular inflammation, and down-stream plaque particle embolization. This review provides an updated overview on the pathomechanism of no-reflow and the current available prevention strategies from the perspective of coronary microcirculation. Although large randomized clinical trials have not yet identified any effective treatment, studying the coronary microcirculation may reveal new therapeutic targets for successful amelioration of the adverse clinical consequences from no-reflow phenomenon.

AB - The coronary no-reflow phenomenon refers to the post-percutaneous coronary intervention (PCI) state in which, despite successful revascularization of the epicardial conduit coronary arteries, substantial regions of the myocardium do not receive adequate perfusion. In most cases, the underlying mechanism can be attributed to alterations in the microvascular circulation caused by factors intrinsic or extrinsic to the coronary microcirculation. Because the no-reflow phenomenon is associated with poor clinical outcomes, it is of great importantance to identify and apply effective strategies for reducing post-PCI morbidity and mortality. Successful prevention strategies aim to ad dress increased vasoreactivity, intravascular platelet aggregation, microvascular inflammation, and down-stream plaque particle embolization. This review provides an updated overview on the pathomechanism of no-reflow and the current available prevention strategies from the perspective of coronary microcirculation. Although large randomized clinical trials have not yet identified any effective treatment, studying the coronary microcirculation may reveal new therapeutic targets for successful amelioration of the adverse clinical consequences from no-reflow phenomenon.

KW - Coronary microcirculation

KW - Microvascular obstruction

KW - No-reflow

UR - http://www.scopus.com/inward/record.url?scp=84901943862&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901943862&partnerID=8YFLogxK

U2 - 10.3909/ricm0699

DO - 10.3909/ricm0699

M3 - Review article

VL - 15

SP - 38

EP - 51

JO - Reviews in Cardiovascular Medicine

JF - Reviews in Cardiovascular Medicine

SN - 1530-6550

IS - 1

ER -