Development and Management of No-Reflow in a Patient Performed Coronary Angiography for Acute Coronary Syndrome: A Case Report

Despite eliminating epicardial coronary artery stenosis or occlusion, insufficient myocardial perfusion is called “no-reflow.” While the no-reflow phenomenon is defined as coronary flow below increased thrombolysis (TIMI) 3 in myocardial infarction in some sources, TIMI is defined as 0–1 flow in some sources. In addition, some publications refer to TIMI 2 flow as slow coronary flow. However, the general view is that TIMI 0–1 coronary flow without severe residual stenosis, spasm, thrombus, or dissection is called no-reflow. The no-reflow phenomenon is a condition in which blood flow is significantly reduced in the ischemic myocardium despite percutaneous coronary intervention. So far, no standard treatment has been established to cure this condition. In this case, we present an interesting case that demonstrates a practical approach to the no-reflow phenomenon.

Keywords: Coronary artery disease; No-reflow phenomenon; Percutaneous transluminal angioplasty