Discussion on the Treatment Methods and Value of the No-Reflow Phenomenon During Percutaneous Coronary Intervention

Abstract

Objective: To explore the treatment methods and value of the no-reflow phenomenon during percutaneous coronary intervention (PCI). Methods: 180 patients with acute myocardial infarction (AMI) who underwent PCI treatment at the First Hospital of Hebei Medical University from November 2020 to December 2022 were selected and divided into Group A, Group B, and Group C by random number table extraction method, each group included 60 cases. Group A received intracoronary injection of recombinant human urokinase and Group B received intracoronary injection of diltiazem. Group C adopted a targeted drug administration strategy of “front and back pinch method,” where targeted thrombolysis was performed in the target vessel before the stent was released to quickly dissolve the residual thrombus near the lesion and the small distal thrombus; recombinant human urokinase was subsequently injected in the targeted vessel. The incidence of cardiovascular events, cardiac function, and quality of life of the three groups were analyzed. Results: After the intervention, the incidence rates of angina pectoris, heart failure, and recurrent myocardial infarction in Group C were lower than those in Group B (P < 0.05); the overall incidence rate was the lowest in Group C, followed by Group A and Group B; after intervention, left ventricular end-diastolic diameter, end-systolic diameter, and ejection fraction in Groups A and C were all better than those of group B (P < 0.05), and Group C was better than Group A; after intervention, the scores of different dimensions of quality of life in Groups A and C were higher than those of Group B (P < 0.05). Conclusion: AMI patients are prone to the no-reflow phenomenon after PCI treatment. Using recombinant human urokinase to complete the “front and back pinch method” can effectively improve the no-reflow phenomenon, reduce the incidence of cardiovascular events, optimize cardiac function, and improve the patient’s quality of life and survival rate.