CBS 2019
CBSMD教育中心
中 文

Other Relevant Articles

Abstract

Recommended Article

Advances in Coronary No-Reflow Phenomenon-a Contemporary Review Management of No-Reflow Phenomenon in the Catheterization Laboratory Major trials in coronary intervention from 2018 Mode of Death in Heart Failure With Preserved Ejection Fraction Cholesterol-Lowering Agents ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2019 Appropriate Use Criteria for Multimodality Imaging in the Assessment of Cardiac Structure and Function in Nonvalvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and the Society of Thoracic Surgeons Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association Update in the Percutaneous Management of Coronary Chronic Total Occlusions

Review Article2018 Jul 5;20(9):44.

JOURNAL:Curr Atheroscler Rep. Article Link

Advances in Coronary No-Reflow Phenomenon-a Contemporary Review

Karimianpour A, Maran A. Keywords: Acute myocardial infarction; Coronary intervention; Microvascular obstruction; Myocardial perfusion; No-reflow; Slow-reflow

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. 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.