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The “no-reflow” phenomenon: basic science and clinical correlates
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  1. Correspondence to:
    Robert A Kloner, MD, PhD, The Heart Institute, Good Samaritan Hospital, University of Southern California, 1225 Wilshire Boulevard, Los Angeles, CA 90017-2395, USA;
    RKloner{at}goodsam.org
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Reffelmann T, Kloner RA
The “no-reflow” phenomenon: basic science and clinical correlates

Publication history

  • First published February 1, 2002.
Online issue publication 
February 01, 2002
  • Web only references

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      Myocardial contrast echocardiography

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      Magnetic resonance imaging

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      Scintigraphic techniques

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      Potential mechanisms of no-reflow

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      Coronary microembolization

      • Yao SK, Ober JC, McNatt J, et al. ADP plays an important role in mediating platelet aggregation and cyclic flow variations in vivo in stenosed and endothelium-injured canine coronary arteries. Circ Res 1992;70:39-48.

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      • Mutin M, Canavy I, Blann A, et al. Direct evidence of endothelial injury in acute myocardial infarction and unstable angina by demonstration of circulating endothelial cells. Blood 1999;93:2951-2958.

      • Mak KH, Challapalli R, Eisenberg MJ, et al., for the EPIC Investigators. Effect of platelet glycoprotein IIb/IIIa receptor inhibition on distal embolization during percutaneous revascularization of aortocoronary saphenous vein grafts. Am J Cardiol 1997;80:985-988.

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      Treatment strategies

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      • Marzilli M, Orsini E, Marraccini P, et al. Beneficial effects of intracoronary adenosine as an adjunct to primary angioplasty in acute myocardial infarction. Circulation 2000;101:2154-2159.

      • Flaherty JT, Pitt B, Gruber JW, et al. Recombinant human superoxide dismutase (h-SOD) fails to improve recovery of ventricular function in patients undergoing coronary angioplasty for acute myocardial infarction. Circulation 1994;89:1982-1991.

      • Ishihara M, Sato H, Tateishi H, et al. Attenuation of the no-reflow phenomenon after coronary angioplasty for acute myocardial infarction with intracoronary papaverine. Am Heart J 1996;132:959-963.

      • Hillegass WB, Dean NA, Liao L, et al. Treatment of no-reflow and impaired flow with the nitric oxide donor nitroprusside following percutaneous interventions: initial human clinical experience. J Am Coll Cardiol 2001; 37:1335-1343.

      • Neumann FJ, Blasini R, Schmitt C, et al. Effect of glycoprotein IIb/IIIa receptor blockade on recovery of coronary flow and left ventricular function after the placement of coronary-artery stents in acute myocardial infarction. Circulation 1998;98:2695-2701.

      • Gibson CM, Cohen DJ, Cohen EA, et al., for the ESPRIT study group. Effect of Eptifibatide on coronary flow reserve following coronary stent implantation (an ESPPRIT substudy). Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy. Am J Cardiol 2001;87:1293-1295.

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