Microvascular obstruction after percutaneous coronary intervention.
Successful revascularization of the epicardial coronary artery can be achieved in over 90% of percutaneous coronary intervention (PCI) procedures. However, postprocedural microvascular obstruction, despite the presence of normal epicardial flow, remains an important limitation which substantially reduces the beneficial effects of PCI. In this review article, a number of different methods available to diagnose microvascular obstruction after PCI are outlined. We also discussed the various pharmacological and mechanical strategies to reduce the occurrence of microvascular obstruction. In this regard, pretreatment with antiplatelet therapy remains crucial. In urgent PCI for acute myocardial infarction, available data suggest that manual thrombus aspiration device is beneficial in reducing the occurrence of procedure-related microvascular obstruction and possibly improve long-term clinical outcomes.
Cardiac Department, National University Heart Center, National University of Singapore, 5, Lower Kent Ridge Road, Singapore 119074. mdclchr@nus.edu.sg
Chi-Hang
CH
Lee
Hung-Fat
HF
Tse
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D002317:Cardiovascular Agents / Q000008:administration & dosage; D003324:Coronary Artery Disease / Q000628:therapy*; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D004617:Embolism / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008833:Microcirculation; D009203:Myocardial Infarction / Q000628:therapy*; D019736:Prostheses and Implants; D017131:Thrombectomy
D002317:Cardiovascular Agents