Coronary Microcirculation and the No-reflow Phenomenon

Title:Coronary Microcirculation and the No-reflow Phenomenon

Volume: 24 Issue: 25

Author(s): Evangelos Oikonomou, Konstantinos Mourouzis, Georgia Vogiatzi, Gerasimos Siasos, Spyridon Deftereos, Spyridon Papaioannou, George Latsios, Sotiris Tsalamandris and Dimitris Tousoulis*

Affiliation:

• 1st Department of Cardiology, ‘Hippokration' Hospital, University of Athens Medical School, Athens,Greece

Keywords: Microcirculation, coronary arteries, coronary circulation, no-reflow, endothelial dysfunction, post-percutaneous coronary intervention.

Abstract: The no-reflow phenomenon refers to the post-percutaneous coronary intervention condition in which, despite re-establishing epicardial coronary vessel patency, the flow to the previously ischemic myocardium is markedly reduced. When it does occur, it attenuates the beneficial effect of reperfusion therapy and substantial regions of the myocardium fail to receive adequate perfusion. The pathophysiology of this phenomenon is not completely understood. The possible mechanisms could be related to alterations in the microvascular circulation. Various mechanisms such as activation of inflammatory pathways, vascular damage and hemorrhage, leukocyte infiltration, and cellular edema may be responsible. As the no-reflow phenomenon is associated with adverse clinical consequences, it is of great importance to identify exact responsible mechanisms and apply effective preventive and therapeutic strategies. In this review, we describe an updated overview of the pathophysiological mechanisms and the current preventive tools for no-reflow as well as therapeutic interventions in order to improve coronary blood flow and consequently the prognosis for these patients.

Cite this article as:

Oikonomou Evangelos , Mourouzis Konstantinos , Vogiatzi Georgia , Siasos Gerasimos , Deftereos Spyridon , Papaioannou Spyridon , Latsios George , Tsalamandris Sotiris and Tousoulis Dimitris *, Coronary Microcirculation and the No-reflow Phenomenon, Current Pharmaceutical Design 2018; 24 (25) . https://dx.doi.org/10.2174/1381612824666180911122230