The No-reflow Phenomenon in Acute Coronary Syndromes: A Comprensive Review

Abstract

Invasive interventions have long been widely used in acute coronary syndromes. Effective reperfusion of the ischemic myocardium should be the primary strategy in patients with acute coronary syndrome. Successful reperfusion is strongly associated with improved clinical outcomes. Conversely, inadequate reperfusion is associated with increased mortality and cardiovascular events in the subsequent period. In some patients, mechanical opening of the coronary arteries is insufficient. Restoring epicardial blood flow does not always ensure microvascular circulation and tissue perfusion. In this microcirculation disorder, called the "no-reflow" phenomenon, there is no mechanical occlusion in the coronary artery, but there is significant myocardial perfusion impairment.