No-Reflow Phenomenon

Abstract

ABSTRACT… Background: Profound reduction in antegrade epicardial coronary flow with concomitant ischemia is seen occasionally during percutaneous coronary intervention despite the absence of evident vessel dissection, obstruction, or distal vessel embolic cutoff. Study Design: Descriptive study. Setting: Khatum-un-Nabyeen Heart Center for percutaneous coronary intervention. Period: January 2016 and December 2016. Methods and Results: Both males and females with age 30 years or more, presented. Patients with coronary angiograms suggestive of percutaneous coronary intervention were included in the study by using nonprobability, purposive sampling technique. Following ethical and research approval from the hospital administration, clinical profile of the patients was documented. Patients presented with acute coronary syndrome as well as patients with stable coronary artery disease requiring coronary intervention based on clinical, ECG, non-invasive test or coronary angiogram were enrolled in the study. Patients with previous history of PCI or CABG were also included in the study. Pregnant patients were excluded from the study. The objective of this study is to find out the incidence of no reflow phenomenon during PCI in our population. The TIMI flow grade was determined for each treated vessel. The criteria for no-reflow was development of substantial flow reduction (less than TIMI 3 flow) in the absence of apparent dissection, thrombosis, or distal vessel cutoff suggestive of macroembolization. SPSS version 16.0 was used for analyzing the data. Frequency and percentages were used for categorical variables. Mean±SD was used for numerical variables. Data were presented in the form of tables. Conclusions: The no-reflow phenomenon, reduction in distal flow without apparent dissection or distal embolization -occurs in 2.25% of coronary interventions.