Rapid reversal of no-reflow using Abciximab after coronary device intervention.
The no-reflow phenomenon is a reduction in epicardial coronary artery blood flow without mechanical vessel obstruction. Early descriptions of this syndrome involved reperfusion after myocardial infarction. More recently, the no-reflow phenomenon has been recognized after brief ischemic times associated with coronary interventions. It is clearly a negative prognostic indicator. The proposed mechanism is multi-factorial and may involve small vessel vasospasm and potentially platelet-mediated loss of capillary autoregulation. Because of the potential role of platelets in the genesis of the no-reflow state, we administered Abciximab to two patients with no-reflow phenomenon following catheter interventions. In both of these settings, rapid distal runoff was reestablished within minutes after treatment with the platelet glycoprotein 2B/3A inhibitor.
Rawitscher
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Hans Hecht Hemodynamics Laboratory, University of Chicago Medical Center, Pritzker School of Medicine, IL 60637, USA.
Levin
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TN
Cohen
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I
Feldman
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T
D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D017225:Atherectomy, Coronary; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000187:drug effects*; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D008297:Male; D015428:Myocardial Reperfusion Injury / Q000000981:diagnostic imaging / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015607:Stents
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab