Restoration of Normal Coronary Flow With Tirofiban by Intracoronary Administration for No-reflow Phenomenon After Stent Deployment

Abstract

SUMMARYNo-reflow phenomenon is frequently observed during percutaneous coronary intervention in patients with acute coronary syndrome. It may jeopardize hemodynamic status or result in ischemic chest pain in these patients. Currently, there is no adequate solution for this problem. We report our experience with an acute coronary syndrome patient who developed no-reflow phenomenon associated with ST segment elevation and shock after percuteneous coronary balloon dilatation and stent deployment. Intracoronary administration of tirofiban immediately restored the coronary flow of the target vessel, and the disastrous condition reversed. Our experience suggests that intracoronary administration of tirofiban can be considered as an option in case of no-reflow phenomenon during percutaneous coronary intervention. (Int Heart J 2005; 46: 139-145)

Position of tirofiban in ST segment elevation myocardial infarction treatment

“…It enhanced epicardial reperfusion rate of fibrinolytics and also improved the flow rate in the infarct-related arteries treated with stent implantation [5][6][7]. Moreover, some medical literatures that has been published recently also propose that tirofiban could dissolve massive intracoronary thrombus [1,8,9]. We also observed a similar effect of tirofiban in both of our cases.…”

Comparison of intracoronary versus intravenous administration of tirofiban in primary percutaneous coronary intervention

“…More recently in a prospective study of 633 STEMI patients who received IC bolus dose of abciximab, the incidence of MACE has been shown to be 3.6% at 30 days and it was lower compared to previous studies (21). The first reported use of IC tirofiban in the thrombus containing coronary artery lesion with no-reflow phenomenon was performed by Yang et al (22). They expressed that coronary flow was immediately restored following the administration of IC tirofiban.…”

Facilitation of Rotablator-Stenting by Measuring Angiographic Lesion Length With the Navicath (type-MUTO), a New Measuring Microcatheter

“…Fourth, the Navicath is useful for rapidly returning the guide wire after ablation. Furthermore, in the case of noreflow phenomenon 5) established after ablation, coronary flow could be steadily restored by infusing nitroprusside 6) and tirofiban 7) from the tip of the Navicath. These were all useful in the rota-stenting procedure.…”