Coronary no reflow in the modern era: a review of advances in diagnostic techniques and contemporary management.

Coronary no reflow in the modern era: a review of advances in diagnostic techniques and contemporary management. Expert Rev Cardiovasc Ther. 2019 Aug 07;: Authors: Kumar J, O'Connor CT, Kumar R, Arnous SK, Kiernan TJ Abstract Introduction: Atherosclerotic coronary artery disease, in particular acute myocardial infarction (AMI) is a leading cause of morbidity and mortality globally. Percutaneous coronary intervention (PCI) is the mainstay of treatment for obstructive coronary artery disease and AMI through the restoration of TIMI III flow. Despite good macrovascular flow, the myocardium can remain hypoperfusion due to poor microvascular perfusion, and this is referred to as "no-reflow". Various treatments have been studied with variable success in both prevention and treatment of no reflow. Areas covered: This review outlines the cutting-edge diagnostic investigations which have been explored in no reflow, allowing a deeper understanding of mechanism and microvascular pathological processes involved in its genesis. These include utility of novel MRI techniques and perfusion echo in conjunction with traditional approaches. Detailed review has been undertaken of both pharmacological and non-pharmacological techniques to prevent and manage microvascular dysfunction associated with no reflow. Particular attention was payed to the evolution and successes of various mechanical protection devices. Expert review: Most promising innovations in...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research