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Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel
Percutaneous coronary intervention (PCI) is a frequently performed procedure that can have minor or major complications. One of the more serious complications of PCI is the development of coronary no-reflow. No-reflow signifies reduced or absent coronary flow in the distal coronary circulation in th...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693477/ https://www.ncbi.nlm.nih.gov/pubmed/38046694 http://dx.doi.org/10.7759/cureus.48182 |
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author | Hussain, Syed W Ramsaran, Eddison |
author_facet | Hussain, Syed W Ramsaran, Eddison |
author_sort | Hussain, Syed W |
collection | PubMed |
description | Percutaneous coronary intervention (PCI) is a frequently performed procedure that can have minor or major complications. One of the more serious complications of PCI is the development of coronary no-reflow. No-reflow signifies reduced or absent coronary flow in the distal coronary circulation in the absence of flow-limiting lesions. We present a case of a middle-aged man who presented as an outpatient for elective coronary angiography due to angina pectoris and a high-risk exercise stress test. Coronary angiography demonstrated significant single-vessel disease with lesions in the proximal and mid-segments of the left anterior descending (LAD) coronary artery. Successful placement of drug-eluting stents in the LAD was followed by a severe drop in blood pressure, worsening chest pain, and ST elevation on telemetry. Immediate angiography showed the development of no-reflow in both the LAD and left circumflex coronary arteries. Ionotropic and intravenous anti-platelet agents were administered with simultaneous placement of an intra-aortic balloon pump, restoring normal flow in both arteries. No-reflow occurs most commonly following PCI in certain lesion subsets, and it is usually seen only in the vessel in which the PCI was performed (culprit vessel). It is important to realize that this phenomenon can occur in other circumstances since immediate recognition and treatment can be lifesaving. |
format | Online Article Text |
id | pubmed-10693477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-106934772023-12-03 Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel Hussain, Syed W Ramsaran, Eddison Cureus Cardiology Percutaneous coronary intervention (PCI) is a frequently performed procedure that can have minor or major complications. One of the more serious complications of PCI is the development of coronary no-reflow. No-reflow signifies reduced or absent coronary flow in the distal coronary circulation in the absence of flow-limiting lesions. We present a case of a middle-aged man who presented as an outpatient for elective coronary angiography due to angina pectoris and a high-risk exercise stress test. Coronary angiography demonstrated significant single-vessel disease with lesions in the proximal and mid-segments of the left anterior descending (LAD) coronary artery. Successful placement of drug-eluting stents in the LAD was followed by a severe drop in blood pressure, worsening chest pain, and ST elevation on telemetry. Immediate angiography showed the development of no-reflow in both the LAD and left circumflex coronary arteries. Ionotropic and intravenous anti-platelet agents were administered with simultaneous placement of an intra-aortic balloon pump, restoring normal flow in both arteries. No-reflow occurs most commonly following PCI in certain lesion subsets, and it is usually seen only in the vessel in which the PCI was performed (culprit vessel). It is important to realize that this phenomenon can occur in other circumstances since immediate recognition and treatment can be lifesaving. Cureus 2023-11-02 /pmc/articles/PMC10693477/ /pubmed/38046694 http://dx.doi.org/10.7759/cureus.48182 Text en Copyright © 2023, Hussain et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiology Hussain, Syed W Ramsaran, Eddison Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel |
title | Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel |
title_full | Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel |
title_fullStr | Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel |
title_full_unstemmed | Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel |
title_short | Development of Multi-Vessel Coronary No-Reflow Following Elective Percutaneous Intervention in One Vessel |
title_sort | development of multi-vessel coronary no-reflow following elective percutaneous intervention in one vessel |
topic | Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693477/ https://www.ncbi.nlm.nih.gov/pubmed/38046694 http://dx.doi.org/10.7759/cureus.48182 |
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