title: Distal administration of very high doses of intracoronary adenosine for the treatment of resistant no-reflow.
abstract: No-reflow is a serious condition, and is associated with substantial morbidity and mortality after percutaneous coronary intervention. The most feared complication of no-reflow is a case of no-reflow that is resistant to multiple drug therapy. This condition usually occurs in patients with distal coronary disease or high thrombus burden. In the present case, a patient with resistant no-reflow that could be reversed by distal intracoronary administration of very high doses of adenosine (1 mg) is described. Administration of very high doses of adenosine via a balloon catheter was safe and did not cause any changes in the heart rate or blood pressure. The present case is the first to be reported in the literature.
authors.affiliation: Department of Medicine, University of Arizona Sarver Heart Center, Southern Arizona VA Health Care System, Tucson, Arizona, USA.
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Movahed
authors.forename: Gurpreet
authors.initials: G
authors.lastname: Baweja