Viewpoint

Low-dose fibrinolysis during primary percutaneous intervention for preventing no-reflow: stepping back to move forward?

EuroIntervention 2022;18:452-455. DOI: 10.4244/EIJ-D-22-00250

Francesco Pelliccia
Francesco Pelliccia1, MD, PhD; Giampaolo Niccoli2, MD, PhD
1. Department of Cardiovascular Sciences, Sapienza University, Rome, Italy; 2. Department of Cardiology, University of Parma, Parma, Italy
Primary percutaneous coronary intervention (PCI) is the gold standard of treatment for ST-elevation acute myocardial infarction (STEMI)1. Although primary PCI restores optimal blood flow in the infarct-related artery (IRA), a sizeable proportion of patients experience the so-called “no-reflow” phenomenon, i.e., they continue to exhibit overt impairment of myocardial reperfusion despite successful opening of the IRA1. No-reflow occurs due to microvascular obstruction (MVO) and has a variable prevalence ranging from 5% up to 60%1. The underlying mechanisms of myocardial injury and MVO are multiple and interacting (Figure 1)1. Above all, an important determinant of MVO is distal embolisation of thrombus debris ...

Sign in to read and download the full article

Forgot your password?

No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Read next article
Treatment of coronary bifurcation lesions, part II: implanting two stents. The 16th expert consensus document of the European Bifurcation Club

Latest news