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Advanced Technical IVT

no-reflow phenomenon

The failure to achieve adequate myocardial perfusion despite successful opening of an epicardial coronary artery.

Full Definition

No-reflow phenomenon describes the inability to restore effective myocardial tissue perfusion following successful mechanical recanalization of an occluded coronary artery, typically occurring during primary percutaneous coronary intervention for acute myocardial infarction. This condition results from microvascular obstruction caused by distal embolization of thrombotic material, inflammation, and microvascular spasm. No-reflow is associated with larger infarct size, reduced left ventricular function, and worse clinical outcomes. Management may include vasodilators, antiplatelet agents, and mechanical devices to prevent or treat microvascular obstruction.

Usage

Usage note: Hyphenate as 'no-reflow' when used as an adjective; distinguish from vessel re-occlusion.

In Context

  • "Despite successful stent deployment, the patient developed no-reflow phenomenon with TIMI 1 flow." — Primary PCI procedure note
  • "Adenosine administration improved coronary flow in this case of no-reflow phenomenon." — Interventional cardiology report

Also known as

microvascular obstruction slow-flow phenomenon

Don't confuse with

vessel reocclusion coronary spasm

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