Distal administration of very high doses of intracoronary adenosine for the treatment of resistant no-reflow.
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.
Movahed
Mohammad-Reza
MR
Department of Medicine, University of Arizona Sarver Heart Center, Southern Arizona VA Health Care System, Tucson, Arizona, USA.
Baweja
Gurpreet
G