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No reflow vascular flow

MedGen UID:
68561
•Concept ID:
C0232347
•
Finding
Synonyms: No Reflow Phenomenon; No-Reflow Phenomenon
SNOMED CT: No reflow vascular flow (67326007); No reflow phenomenon (67326007)

Definition

Markedly reduced or absent REPERFUSION in an infarct zone following the removal of an obstruction or constriction of an artery. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNo reflow vascular flow

Professional guidelines

PubMed

Below-the-Knee Endovascular Revascularization: A Position Statement.
Li J, Varcoe R, Manzi M, Kum S, Iida O, Schmidt A, Shishehbor MH
JACC Cardiovasc Interv 2024 Mar 11;17(5):589-607. Epub 2024 Jan 17 doi: 10.1016/j.jcin.2023.11.040. PMID: 38244007
Saphenous Vein Graft Failure: From Pathophysiology to Prevention and Treatment Strategies.
Xenogiannis I, Zenati M, Bhatt DL, Rao SV, Rodés-Cabau J, Goldman S, Shunk KA, Mavromatis K, Banerjee S, Alaswad K, Nikolakopoulos I, Vemmou E, Karacsonyi J, Alexopoulos D, Burke MN, Bapat VN, Brilakis ES
Circulation 2021 Aug 31;144(9):728-745. Epub 2021 Aug 30 doi: 10.1161/CIRCULATIONAHA.120.052163. PMID: 34460327
Intracoronary pharmacotherapy in the management of coronary microvascular dysfunction.
Kunadian V, Zorkun C, Williams SP, Biller LH, Palmer AM, Ogando KJ, Lew ME, Nethala N, Gibson WJ, Marble SJ, Buros JL, Gibson CM
J Thromb Thrombolysis 2008 Dec;26(3):234-42. Epub 2008 Sep 26 doi: 10.1007/s11239-008-0276-0. PMID: 18818881

Recent clinical studies

Etiology

The Association of a PRECISE-DAPT Score With No-Reflow in Patients With ST-Segment Elevation Myocardial Infarction.
Selçuk M, Çınar T, Şaylık F, Demiroz Ö, Yıldırım E
Angiology 2022 Jan;73(1):68-72. Epub 2021 Apr 21 doi: 10.1177/00033197211010602. PMID: 33878953
No-reflow phenomenon in ST-segment elevation myocardial infarction: still the Achilles' heel of the interventionalist.
Ciofani JL, Allahwala UK, Scarsini R, Ekmejian A, Banning AP, Bhindi R, De Maria GL
Future Cardiol 2021 Mar;17(2):383-397. Epub 2020 Sep 11 doi: 10.2217/fca-2020-0077. PMID: 32915083
Pathophysiology and diagnosis of coronary microvascular dysfunction in ST-elevation myocardial infarction.
Konijnenberg LSF, Damman P, Duncker DJ, Kloner RA, Nijveldt R, van Geuns RM, Berry C, Riksen NP, Escaned J, van Royen N
Cardiovasc Res 2020 Mar 1;116(4):787-805. doi: 10.1093/cvr/cvz301. PMID: 31710673Free PMC Article
Invasive Assessment of the Coronary Microcirculation in Reperfused ST-Segment-Elevation Myocardial Infarction Patients: Where Do We Stand?
Bulluck H, Foin N, Tan JW, Low AF, Sezer M, Hausenloy DJ
Circ Cardiovasc Interv 2017 Mar;10(3) doi: 10.1161/CIRCINTERVENTIONS.116.004373. PMID: 28242607
Novel insights into an "old" phenomenon: the no reflow.
Durante A, Camici PG
Int J Cardiol 2015;187:273-80. Epub 2015 Mar 26 doi: 10.1016/j.ijcard.2015.03.359. PMID: 25838230

Diagnosis

Pathophysiology and diagnosis of coronary microvascular dysfunction in ST-elevation myocardial infarction.
Konijnenberg LSF, Damman P, Duncker DJ, Kloner RA, Nijveldt R, van Geuns RM, Berry C, Riksen NP, Escaned J, van Royen N
Cardiovasc Res 2020 Mar 1;116(4):787-805. doi: 10.1093/cvr/cvz301. PMID: 31710673Free PMC Article
Novel insights into an "old" phenomenon: the no reflow.
Durante A, Camici PG
Int J Cardiol 2015;187:273-80. Epub 2015 Mar 26 doi: 10.1016/j.ijcard.2015.03.359. PMID: 25838230
Cardiac MR assessment of microvascular obstruction.
Abbas A, Matthews GH, Brown IW, Shambrook JS, Peebles CR, Harden SP
Br J Radiol 2015 Mar;88(1047):20140470. Epub 2014 Dec 4 doi: 10.1259/bjr.20140470. PMID: 25471092Free PMC Article
The no-reflow phenomenon.
Galiuto L, Rebuzzi AG, Crea F
JACC Cardiovasc Imaging 2009 Jan;2(1):85-6. doi: 10.1016/j.jcmg.2008.11.003. PMID: 19356539
No-reflow phenomenon.
Rezkalla SH, Kloner RA
Circulation 2002 Feb 5;105(5):656-62. doi: 10.1161/hc0502.102867. PMID: 11827935

Therapy

No-Reflow After Primary PCI: Will Distal Intracoronary Medication Do the Trick?
Beijnink CWH, Woelders ECI, van Geuns RJM
Cardiovasc Revasc Med 2023 Feb;47:5-7. Epub 2022 Dec 14 doi: 10.1016/j.carrev.2022.12.002. PMID: 36682836
Pathophysiology and diagnosis of coronary microvascular dysfunction in ST-elevation myocardial infarction.
Konijnenberg LSF, Damman P, Duncker DJ, Kloner RA, Nijveldt R, van Geuns RM, Berry C, Riksen NP, Escaned J, van Royen N
Cardiovasc Res 2020 Mar 1;116(4):787-805. doi: 10.1093/cvr/cvz301. PMID: 31710673Free PMC Article
Myocardial no-reflow treatment.
Muller O, Trana C, Eeckhout E
Curr Vasc Pharmacol 2013 Mar 1;11(2):278-85. PMID: 23506504
'No-reflow' phenomenon.
Nadelson JD, Vidovich MI
Cardiol J 2012;19(3):328-9. doi: 10.5603/cj.2012.0060. PMID: 22641557
The no-reflow phenomenon.
Galiuto L, Rebuzzi AG, Crea F
JACC Cardiovasc Imaging 2009 Jan;2(1):85-6. doi: 10.1016/j.jcmg.2008.11.003. PMID: 19356539

Prognosis

"No-reflow" phenomenon in acute ischemic stroke.
Zhang Y, Jiang M, Gao Y, Zhao W, Wu C, Li C, Li M, Wu D, Wang W, Ji X
J Cereb Blood Flow Metab 2024 Jan;44(1):19-37. Epub 2023 Oct 19 doi: 10.1177/0271678X231208476. PMID: 37855115Free PMC Article
Pathophysiology and diagnosis of coronary microvascular dysfunction in ST-elevation myocardial infarction.
Konijnenberg LSF, Damman P, Duncker DJ, Kloner RA, Nijveldt R, van Geuns RM, Berry C, Riksen NP, Escaned J, van Royen N
Cardiovasc Res 2020 Mar 1;116(4):787-805. doi: 10.1093/cvr/cvz301. PMID: 31710673Free PMC Article
What imaging modality do you want to select for prediction of the no-reflow phenomenon?
Yajima J
J Cardiol 2013 Aug;62(2):138-9. Epub 2013 Jul 1 doi: 10.1016/j.jjcc.2013.05.013. PMID: 23827050
'No-reflow' phenomenon.
Nadelson JD, Vidovich MI
Cardiol J 2012;19(3):328-9. doi: 10.5603/cj.2012.0060. PMID: 22641557
The no-reflow phenomenon.
Galiuto L, Rebuzzi AG, Crea F
JACC Cardiovasc Imaging 2009 Jan;2(1):85-6. doi: 10.1016/j.jcmg.2008.11.003. PMID: 19356539

Clinical prediction guides

Slow-Flow Phenomenon Caused by Distal Embolization Should Be Predicted and Prevented to Maximize the Efficacy of Coronary Intervention.
Ueda Y
Circ J 2024 May 24;88(6):980-981. Epub 2023 Oct 20 doi: 10.1253/circj.CJ-23-0702. PMID: 37866909
The Association of a PRECISE-DAPT Score With No-Reflow in Patients With ST-Segment Elevation Myocardial Infarction.
Selçuk M, Çınar T, Şaylık F, Demiroz Ö, Yıldırım E
Angiology 2022 Jan;73(1):68-72. Epub 2021 Apr 21 doi: 10.1177/00033197211010602. PMID: 33878953
Pathophysiology and diagnosis of coronary microvascular dysfunction in ST-elevation myocardial infarction.
Konijnenberg LSF, Damman P, Duncker DJ, Kloner RA, Nijveldt R, van Geuns RM, Berry C, Riksen NP, Escaned J, van Royen N
Cardiovasc Res 2020 Mar 1;116(4):787-805. doi: 10.1093/cvr/cvz301. PMID: 31710673Free PMC Article
Invasive Assessment of the Coronary Microcirculation in Reperfused ST-Segment-Elevation Myocardial Infarction Patients: Where Do We Stand?
Bulluck H, Foin N, Tan JW, Low AF, Sezer M, Hausenloy DJ
Circ Cardiovasc Interv 2017 Mar;10(3) doi: 10.1161/CIRCINTERVENTIONS.116.004373. PMID: 28242607
The no-reflow phenomenon.
Galiuto L, Rebuzzi AG, Crea F
JACC Cardiovasc Imaging 2009 Jan;2(1):85-6. doi: 10.1016/j.jcmg.2008.11.003. PMID: 19356539

Recent systematic reviews

No-reflow phenomenon in stroke patients: A systematic literature review and meta-analysis of clinical data.
Mujanovic A, Ng F, Meinel TR, Dobrocky T, Piechowiak EI, Kurmann CC, Seiffge DJ, Wegener S, Wiest R, Meyer L, Fiehler J, Olivot JM, Ribo M, Nguyen TN, Gralla J, Campbell BC, Fischer U, Kaesmacher J
Int J Stroke 2024 Jan;19(1):58-67. Epub 2023 Jun 8 doi: 10.1177/17474930231180434. PMID: 37231702
Therapeutic and safety outcomes of intracoronary nicardipine in coronary artery disease patients: a systematic review.
Rehan ST, Imran L, Salim A, Javed SO, Sohail A, Hussain HU, Ahmed J, Yasmin F, Islam MS, Asghar MS
Future Cardiol 2023 Mar;19(3):163-174. Epub 2023 Jun 2 doi: 10.2217/fca-2022-0085. PMID: 37264944
Delayed vs. immediate stenting in STEMI with a high thrombus burden : A systematic review and meta-analysis.
Sun B, Liu J, Yin H, Yang S, Liu Z, Chen T, Li J, Guo C, Jiang Z
Herz 2019 Dec;44(8):726-734. Epub 2018 Apr 12 doi: 10.1007/s00059-018-4699-x. PMID: 29651617
Adenosine and verapamil for no-reflow during primary percutaneous coronary intervention in people with acute myocardial infarction.
Su Q, Nyi TS, Li L
Cochrane Database Syst Rev 2015 May 18;2015(5):CD009503. doi: 10.1002/14651858.CD009503.pub3. PMID: 25985145Free PMC Article
Adenosine and verapamil for no-reflow during primary percutaneous coronary intervention in people with acute myocardial infarction.
Aung Naing K, Li L, Su Q, Wu T
Cochrane Database Syst Rev 2013 Jun 4;(6):CD009503. doi: 10.1002/14651858.CD009503.pub2. PMID: 23736949

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