no-reflow
Inadequate myocardial perfusion despite successful epicardial coronary artery reopening during PCI.
Full Definition
No-reflow phenomenon describes the inadequate restoration of myocardial tissue perfusion despite successful mechanical reopening of the epicardial coronary artery during percutaneous coronary intervention. This occurs due to microvascular dysfunction caused by distal embolization, vasospasm, or tissue edema. No-reflow is associated with larger infarct size, reduced left ventricular function, and increased mortality. It can be assessed angiographically by TIMI flow grade or myocardial blush grade, and may require treatment with vasodilators or antiplatelet agents.
Usage
Usage note: Often written as hyphenated compound; distinguish from slow flow states.
In Context
- "Despite successful stent deployment, the patient developed no-reflow requiring intracoronary verapamil." — Cardiac catheterization report
- "No-reflow was evident by absent myocardial blush despite TIMI 3 epicardial flow." — Interventional procedure note