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Related Experiment Video

Updated: May 13, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

Myocardial no-reflow treatment.

Olivier Muller¹, Catalina Trana, Eric Eeckhout

¹Cardiology department, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, Lausanne, Switzerland.

Current Vascular Pharmacology

|March 20, 2013

Summary

The no-reflow phenomenon, a complication of percutaneous coronary intervention (PCI), can be managed through pharmacological agents or mechanical strategies. This review explores current literature on treating no-reflow, despite limited clinical endpoint data.

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Area of Science:

Cardiology
Interventional Cardiology

Background:

The no-reflow phenomenon is a common complication following percutaneous coronary intervention (PCI), particularly in myocardial infarction.
It can also occur in stable angina patients undergoing specific PCI techniques like rotational ablation or saphenous vein graft angioplasty.

Purpose of the Study:

To review and summarize current pharmacological and mechanical treatment strategies for the no-reflow phenomenon.
To present a treatment algorithm for no-reflow based on existing literature.

Main Methods:

Literature review of pharmacological agents (adenosine, nitroprusside, verapamil, nicorandil, dipyridamole, epinephrine, cyclosporine).
Literature review of mechanical strategies (intra-aortic balloon pumping, postconditioning).

Main Results:

Several pharmacological compounds have been assessed for no-reflow treatment.
Limited mechanical strategies like intra-aortic balloon pumping and postconditioning have been examined.
No studies demonstrated a definitive beneficial effect on clinical endpoints for any treatment.

Conclusions:

Current literature provides insights into pharmacological and mechanical approaches for no-reflow.
An algorithm for no-reflow management is proposed, acknowledging the lack of clinical endpoint evidence.
Further research is needed to establish effective treatments with proven clinical benefits.