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Updated: Aug 8, 2026
Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency
Published on: January 15, 2017
[No-reflow phenomenon following PCI of venous graft -- a case report]
Maciej Dabrowski1, Adam Witkowski, Krzysztof Kukuła
1I Klinika Choroby Wieńcowej, Instytut Kardiologii, ul. Alpejska 42, 04-628 Warszawa. macidabro@yahoo.com
Insights
This case study highlights complications following percutaneous coronary intervention (PCI) in a patient with severe coronary artery disease, including stroke and the no-reflow phenomenon, ultimately leading to heart failure. Management of the no-reflow phenomenon is crucial in high-risk cardiac patients.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- A 72-year-old male with extensive coronary artery disease (CAD), history of two myocardial infarctions, and reduced ejection fraction (30%) underwent coronary artery bypass grafting (CABG) in 1990.
- The patient had previously undergone percutaneous coronary intervention (PCI) in 2001 for two grafts, which was complicated by ischemic stroke.
Observation:
- In 2003, the patient underwent repeat PCI for an occluded venous graft.
- This procedure was complicated by the no-reflow phenomenon and acute myocardial infarction.
- Following these events, a cardiac resynchronization pacing system was implanted, leading to initial improvement.
Findings:
- Despite initial improvement, the patient succumbed to progressive heart failure one year after the implantation of the cardiac resynchronization pacing system.
- The case underscores the challenges in managing complex coronary artery disease and procedural complications.
Implications:
- Effective diagnosis and management strategies for the no-reflow phenomenon are critical in interventional cardiology.
- This case emphasizes the importance of careful patient selection and risk stratification in complex PCI procedures.
- Understanding and mitigating procedural complications like stroke and no-reflow are vital for improving patient outcomes in advanced coronary artery disease.
Abstract:
A case of a 72-year-old male with coronary artery disease, history of two myocardial infarctions, ejection fraction of 30% and CABG performed in 1990, is described. In 2001 he underwent PCI of two grafts. The procedure was complicated by ischaemic stroke. In 2003 the patient underwent another PCI of the occluded venous graft which was complicated by no-reflow phenomenon and acute myocardial infarction. A few months later cardiac resynchronization pacing system was implanted. The patient improved, however, one year later died due to progressive heart failure. Diagnosis and treatment of the no reflow phenomenon are discussed.
