No-reflow case 1

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Percutaneous coronary intervention Microchapters

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Patient Information

Overview

Risk Stratification and Benefits of PCI

Preparation of the Patient for PCI

Equipment Used During PCI

Pharmacotherapy to Support PCI

Vascular Closure Devices

Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT

Post-PCI Management

Risk Reduction After PCI

Post-PCI follow up

Hybrid coronary revascularization

PCI approaches

PCI Complications

Factors Associated with Complications
Vessel Perforation
Dissection
Distal Embolization
No-reflow
Coronary Vasospasm
Abrupt Closure
Access Site Complications
Peri-procedure Bleeding
Restenosis
Renal Failure
Thrombocytopenia
Late Acquired Stent Malapposition
Loss of Side Branch
Multiple Complications

PCI in Specific Patients

Cardiogenic Shock
Left Main Coronary Artery Disease
Refractory Ventricular Arrhythmia
Severely Depressed Ventricular Function
Sole Remaining Conduit
Unprotected Left Main Patient
Adjuncts for High Risk PCI

PCI in Specific Lesion Types

Classification of the Lesion
The Calcified Lesion
The Ostial Lesion
The Angulated or Tortuous Lesion
The Bifurcation Lesion
The Long Lesion
The Bridge Lesion
Vasospasm
The Chronic Total Occlusion
The Left Internal Mammary Artery
Multivessel Disease
Distal Anastomotic Lesions
Left Main Intervention
The Thrombotic Lesion

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hardik Patel, M.D., Sapan Patel M.B.B.S

No-Reflow

Pre-intervention

Shown below is a pre-intervention angiogram with occlusion in the proximal part of SVG (saphenous vein graft) to the RCA.

Normal speed
Slow motion

Intervention

Shown below is an angiogram with ongoing intervention on the occlusion described above.

Post-intervention

Shown below is a post-intervention angiogram with acute reduction in blood flow (TIMI flow grade 1) in the absence of dissection, thrombus, spasm, or high-grade residual stenosis in the SVG (saphenous vein graft) depicting no-reflow.

Normal speed
Slow motion

Shown below is a post-intervention angiogram with a complete restoration of blood flow (TIMI flow grade 3) after transient no-reflow as depicted above.

Normal speed
Slow motion

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