title: New strategies for the management of no-reflow after primary percutaneous coronary intervention.
abstract: The myocardial no-reflow phenomenon is characterized by a reduced antegrade myocardial blood flow despite an open infarct-related artery in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Importantly, no-reflow is known to be associated with unfavorable clinical outcome and prognosis. It is a complex phenomenon and is caused by the variable combination of four pathogenetic components: distal atherothrombotic embolization, ischemic injury, reperfusion injury and susceptibility of coronary microcirculation to injury. As a consequence, appropriate strategies to prevent or treat each of these components are expected to reduce the occurrence of no-reflow. Mechanical and pharmacological approaches performed before, during and after performing myocardial revascularization have been investigated in recent studies, in order to reduce the rate of no-reflow. In this article, we concentrate on the major preventive and therapeutic approaches currently available for the management of the no-reflow phenomenon.
authors: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy. gniccoli73@hotmail.it
authors: Giampaolo
authors: G
authors: Niccoli
authors: Nicola
authors: N
authors: Cosentino
authors: Cristina
authors: C
authors: Spaziani
authors: Silvia
authors: S
authors: Minelli
authors: Francesco
authors: F
authors: Fracassi
authors: Filippo
authors: F
authors: Crea