Coronary microvascular obstruction (the no-reflow phenomenon) during percutaneous coronary interventions in patients with myocardial infarction

Abstract

Coronary microvascular obstruction (the no-reflow phenomenon) after percutaneous coronary interventions in diagnosed with myocardial infarction has a significant negative impact on both the short-term and long-term prognosis. The mechanisms underlying this disorder are heterogeneous and complex, and as such it is difficult to devise effective treatments and/or to predict specific outcomes. Modern therapeutic approaches have indirect cardioprotective effects and certainly reduce the risk of no-reflow. However, attempts to create a drug or method that fundamentally improve the prognosis in patients with coronary microvascular obstruction have been unsuccessful. Thus, the problem of myocardial reperfusion damage has not been solved and further study will be necessary to provide support for the search for new therapeutic modalities. The purpose of this review is to provide an analysis of relevant literature that focuses on the aetiology, pathogenesis, diagnosis, prognosis and treatment of the coronary microvascular obstruction during and after percutaneous coronary interventions in patients diagnosed with myocardial infarction. We searched using the Medline (PubMed), RSCI (eLIBRARY), Embase and Google Scholar databases for all relevant literature pertaining to this subject.Received 13 January 2020. Accepted 11 February 2020.Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest.