Journal of Clinical Medicine (Apr 2022)

“No-Reflow” Phenomenon: A Contemporary Review

  • Gianmarco Annibali,
  • Innocenzo Scrocca,
  • Tiziana Claudia Aranzulla,
  • Emanuele Meliga,
  • Francesco Maiellaro,
  • Giuseppe Musumeci

DOI
https://doi.org/10.3390/jcm11082233
Journal volume & issue
Vol. 11, no. 8
p. 2233

Abstract

Read online

Primary percutaneous angioplasty (pPCI), represents the reperfusion strategy of choice for patients with STEMI according to current international guidelines of the European Society of Cardiology. Coronary no-reflow is characterized by angiographic evidence of slow or no anterograde epicardial flow, resulting in inadequate myocardial perfusion in the absence of evidence of mechanical vessel obstruction. No reflow (NR) is related to a functional and structural alteration of the coronary microcirculation and we can list four main pathophysiological mechanisms: distal atherothrombotic embolization, ischemic damage, reperfusion injury, and individual susceptibility to microvascular damage. This review will provide a contemporary overview of the pathogenesis, diagnosis, and treatment of NR.

Keywords