The Use of Intracoronary Sodium Nitroprusside to Treat No-Reflow after Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction
Background: The no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The incidence of no-reflow appears to be highest in patients undergoing primary percutaneous coronary intervention (PCI) in acute myocardial infa...
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| Published in: | Herz Vol. 35; no. 2; pp. 114 - 118 |
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| Format: | Journal Article |
| Language: | English |
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Munchen
Urban and Vogel
01-03-2010
Springer Nature B.V |
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| Abstract | Background:
The no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The incidence of no-reflow appears to be highest in patients undergoing primary percutaneous coronary intervention (PCI) in acute myocardial infarction or during PCI of saphenous vein grafts (SVGs). Treatment of no-reflow phenomenon is based on the intracoronary administration of medications that induce vasodilatation in small distal coronary vasculature. Sodium nitroprusside (NTP) is a direct nitric oxide donor and does not require intracellular metabolism to induce vasodilatation in microcirculation.
Case Study:
Two patients are reported, in whom no-reflow following primary PCI of SVG and native coronary artery was successfully treated with intracoronary NTP. Repeated injections of 50 μg NTP were given selectively distal to the occlusion site utilizing coronary microcatheter (a total NTP dose of 200 μg was given in both cases). Because of the extremely short half-life, the use of intracoronary NTP was easily tolerated by both patients, without causing prolonged or profound hypotension.
Conclusion:
The authors therefore propose the use of NTP for treatment of no-reflow phenomenon in both vein grafts and native coronary arteries in the setting of acute myocardial infarction. |
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| AbstractList | The no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The incidence of no-reflow appears to be highest in patients undergoing primary percutaneous coronary intervention (PCI) in acute myocardial infarction or during PCI of saphenous vein grafts (SVGs). Treatment of no-reflow phenomenon is based on the intracoronary administration of medications that induce vasodilatation in small distal coronary vasculature. Sodium nitroprusside (NTP) is a direct nitric oxide donor and does not require intracellular metabolism to induce vasodilatation in microcirculation.
Two patients are reported, in whom no-reflow following primary PCI of SVG and native coronary artery was successfully treated with intracoronary NTP. Repeated injections of 50 microg NTP were given selectively distal to the occlusion site utilizing coronary microcatheter (a total NTP dose of 200 microg was given in both cases). Because of the extremely short half-life, the use of intracoronary NTP was easily tolerated by both patients, without causing prolonged or profound hypotension.
The authors therefore propose the use of NTP for treatment of no-reflow phenomenon in both vein grafts and native coronary arteries in the setting of acute myocardial infarction. BACKGROUNDThe no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The incidence of no-reflow appears to be highest in patients undergoing primary percutaneous coronary intervention (PCI) in acute myocardial infarction or during PCI of saphenous vein grafts (SVGs). Treatment of no-reflow phenomenon is based on the intracoronary administration of medications that induce vasodilatation in small distal coronary vasculature. Sodium nitroprusside (NTP) is a direct nitric oxide donor and does not require intracellular metabolism to induce vasodilatation in microcirculation. CASE STUDYTwo patients are reported, in whom no-reflow following primary PCI of SVG and native coronary artery was successfully treated with intracoronary NTP. Repeated injections of 50 microg NTP were given selectively distal to the occlusion site utilizing coronary microcatheter (a total NTP dose of 200 microg was given in both cases). Because of the extremely short half-life, the use of intracoronary NTP was easily tolerated by both patients, without causing prolonged or profound hypotension. CONCLUSIONThe authors therefore propose the use of NTP for treatment of no-reflow phenomenon in both vein grafts and native coronary arteries in the setting of acute myocardial infarction. The no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The incidence of no-reflow appears to be highest in patients undergoing primary percutaneous coronary intervention (PCI) in acute myocardial infarction or during PCI of saphenous vein grafts (SVGs). Treatment of no-reflow phenomenon is based on the intracoronary administration of medications that induce vasodilatation in small distal coronary vasculature. Sodium nitroprusside (NTP) is a direct nitric oxide donor and does not require intracellular metabolism to induce vasodilatation in microcirculation. Two patients are reported, in whom no-reflow following primary PCI of SVG and native coronary artery was successfully treated with intracoronary NTP. Repeated injections of 50 μg NTP were given selectively distal to the occlusion site utilizing coronary microcatheter (a total NTP dose of 200 μg was given in both cases). Because of the extremely short half-life, the use of intracoronary NTP was easily tolerated by both patients, without causing prolonged or profound hypotension. The authors therefore propose the use of NTP for treatment of no-reflow phenomenon in both vein grafts and native coronary arteries in the setting of acute myocardial infarction.[PUBLICATION ABSTRACT] Background: The no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The incidence of no-reflow appears to be highest in patients undergoing primary percutaneous coronary intervention (PCI) in acute myocardial infarction or during PCI of saphenous vein grafts (SVGs). Treatment of no-reflow phenomenon is based on the intracoronary administration of medications that induce vasodilatation in small distal coronary vasculature. Sodium nitroprusside (NTP) is a direct nitric oxide donor and does not require intracellular metabolism to induce vasodilatation in microcirculation. Case Study: Two patients are reported, in whom no-reflow following primary PCI of SVG and native coronary artery was successfully treated with intracoronary NTP. Repeated injections of 50 μg NTP were given selectively distal to the occlusion site utilizing coronary microcatheter (a total NTP dose of 200 μg was given in both cases). Because of the extremely short half-life, the use of intracoronary NTP was easily tolerated by both patients, without causing prolonged or profound hypotension. Conclusion: The authors therefore propose the use of NTP for treatment of no-reflow phenomenon in both vein grafts and native coronary arteries in the setting of acute myocardial infarction. |
| Author | Tesic, Milorad B. Ostojic, Miodrag C. Stankovic, Goran Vukcevic, Vladan |
| Author_xml | – sequence: 1 givenname: Milorad B. surname: Tesic fullname: Tesic, Milorad B. organization: Department of Cardiology, Clinical Center of Serbia – sequence: 2 givenname: Goran surname: Stankovic fullname: Stankovic, Goran email: gorastan@sbb.rs organization: Department of Cardiology, Clinical Center of Serbia, Department of Cardiology, Clinical Center of Serbia – sequence: 3 givenname: Vladan surname: Vukcevic fullname: Vukcevic, Vladan organization: Department of Cardiology, Clinical Center of Serbia – sequence: 4 givenname: Miodrag C. surname: Ostojic fullname: Ostojic, Miodrag C. organization: Department of Cardiology, Clinical Center of Serbia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20376646$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.ahj.2006.05.010 10.1002/ccd.21715 10.1016/j.jacc.2004.03.058 10.1016/S0140-6736(89)92271-X 10.1002/ccd.20149 10.1016/j.amjcard.2006.10.057 10.2174/187152508783955079 10.1016/S0735-1097(01)01138-X 10.1016/j.amjcard.2005.01.082 10.1139/Y07-013 10.1080/17482940701744318 |
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| DocumentTitle_FL | Die intrakoronare Anwendung von Nitroprussidnatrium zur Behandlung vaskulärer Reperfusionsschäden durch das No-Reflow-Phänomen nach primärer perkutaner koronarer Intervention bei akutem Myokardinfarkt |
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| Keywords | SVG Complications Aortokoronarer Venenbypass Percutaneous coronary intervention Stent No-reflow Sodium nitroprusside No-Reflow-Phänomen Komplikation Nitroprussidnatrium PCI Perkutane koronare Intervention Stents |
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| References | Fischell (CR4) 2008; 20 Wilson, Laxson, Lesser, White (CR5) 1989; 1 Hillegass, Dean, Liao (CR6) 2001; 37 Lee, Norell (CR10) 2008; 10 Amit, Cafri, Yaroslavtsev (CR8) 2006; 152 Rezkalla, Kloner (CR1) 2008; 72 Valero, Moreno, Reyes (CR2) 2008; 6 Costantini, Stone, Mehran (CR3) 2004; 44 Pasceri, Pristipino, Pelliccia (CR9) 2005; 95 Parikh, Chag, Shah (CR11) 2007; 85 Wang, Lo, Lin (CR12) 2004; 63 Airoldi, Briguori, Cianflone (CR7) 2007; 99 17070151 - Am Heart J. 2006 Nov;152(5):887.e9-14 15261923 - J Am Coll Cardiol. 2004 Jul 21;44(2):305-12 19021281 - Catheter Cardiovasc Interv. 2008 Dec 1;72(7):950-7 2564903 - Lancet. 1989 Apr 15;1(8642):807-11 17612657 - Can J Physiol Pharmacol. 2007 Mar-Apr;85(3-4):476-82 18473777 - Cardiovasc Hematol Agents Med Chem. 2008 Apr;6(2):125-9 17398183 - Am J Cardiol. 2007 Apr 1;99(7):916-20 11300444 - J Am Coll Cardiol. 2001 Apr;37(5):1335-43 15390241 - Catheter Cardiovasc Interv. 2004 Oct;63(2):171-6 18449813 - Acute Card Care. 2008;10 (1):5-14 15904643 - Am J Cardiol. 2005 Jun 1;95(11):1358-61 18599901 - J Invasive Cardiol. 2008 Jul;20(7):374-9 W.B. Hillegass (3243_CR6) 2001; 37 R.F. Wilson (3243_CR5) 1989; 1 T.A. Fischell (3243_CR4) 2008; 20 C.O. Costantini (3243_CR3) 2004; 44 G. Amit (3243_CR8) 2006; 152 H.J. Wang (3243_CR12) 2004; 63 F. Airoldi (3243_CR7) 2007; 99 S.H. Rezkalla (3243_CR1) 2008; 72 V. Pasceri (3243_CR9) 2005; 95 K.H. Parikh (3243_CR11) 2007; 85 K.W. Lee (3243_CR10) 2008; 10 S.J. Valero (3243_CR2) 2008; 6 |
| References_xml | – volume: 152 start-page: 887 year: 2006 ident: CR8 article-title: Intracoronary nitroprusside for the prevention of the no-reflow phenomenon after primary percutaneous coronary intervention in acute myocardial infarction. A randomized, double-blind, placebo-controlled clinical trial publication-title: Am Heart J doi: 10.1016/j.ahj.2006.05.010 contributor: fullname: Yaroslavtsev – volume: 72 start-page: 950 year: 2008 end-page: 957 ident: CR1 article-title: Coronary no-reflow phenomenon: from the experimental laboratory to the cardiac catheterization laboratory publication-title: Catheter Cardiovasc Interv doi: 10.1002/ccd.21715 contributor: fullname: Kloner – volume: 44 start-page: 305 year: 2004 end-page: 312 ident: CR3 article-title: Frequency, correlates, and clinical implications of myocardial perfusion after primary angioplasty and stenting, with and without glycoprotein IIb/IIIa inhibition, in acute myocardial infarction publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2004.03.058 contributor: fullname: Mehran – volume: 1 start-page: 807 year: 1989 end-page: 811 ident: CR5 article-title: Intense microvascular constriction after angioplasty of acute thrombotic coronary arterial lesions publication-title: Lancet doi: 10.1016/S0140-6736(89)92271-X contributor: fullname: White – volume: 63 start-page: 171 year: 2004 end-page: 176 ident: CR12 article-title: Treatment of slow/no-reflow phenomenon with intracoronary nitroprusside injection in primary coronary intervention for acute myocardial infarction publication-title: Catheter Cardiovasc Interv doi: 10.1002/ccd.20149 contributor: fullname: Lin – volume: 20 start-page: 374 year: 2008 end-page: 379 ident: CR4 article-title: Pharmaceutical interventions for the management of no-reflow publication-title: J Invasive Cardiol contributor: fullname: Fischell – volume: 99 start-page: 916 year: 2007 end-page: 920 ident: CR7 article-title: Frequency of slow coronary flow following successful stent implantation and effect of nitroprusside publication-title: Am J Cardiol doi: 10.1016/j.amjcard.2006.10.057 contributor: fullname: Cianflone – volume: 6 start-page: 125 year: 2008 end-page: 129 ident: CR2 article-title: Pharmacological approach of no-reflow phenomenon related with percutaneous coronary interventions publication-title: Cardiovasc Hematol Agents Med Chem doi: 10.2174/187152508783955079 contributor: fullname: Reyes – volume: 37 start-page: 1335 year: 2001 end-page: 1343 ident: CR6 article-title: Treatment of no-reflow and impaired flow with the nitric oxide donor nitroprusside following percutaneous coronary interventions: initial human clinical experience publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(01)01138-X contributor: fullname: Liao – volume: 95 start-page: 1358 year: 2005 end-page: 1361 ident: CR9 article-title: Effects of the nitric oxide donor nitroprusside on no-reflow phenomenon during coronary interventions for acute myocardial infarction publication-title: Am J Cardiol doi: 10.1016/j.amjcard.2005.01.082 contributor: fullname: Pelliccia – volume: 85 start-page: 476 year: 2007 end-page: 482 ident: CR11 article-title: Intracoronary boluses of adenosine and sodium nitroprusside in combination reverses slow/no-reflow during angioplasty: a clinical scenario of ischemic preconditioning publication-title: Can J Physiol Pharmacol doi: 10.1139/Y07-013 contributor: fullname: Shah – volume: 10 start-page: 5 year: 2008 end-page: 14 ident: CR10 article-title: Management of “no-reflow” complicating reperfusion therapy publication-title: Acute Card Care doi: 10.1080/17482940701744318 contributor: fullname: Norell – volume: 44 start-page: 305 year: 2004 ident: 3243_CR3 publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2004.03.058 contributor: fullname: C.O. 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Parikh – volume: 1 start-page: 807 year: 1989 ident: 3243_CR5 publication-title: Lancet doi: 10.1016/S0140-6736(89)92271-X contributor: fullname: R.F. Wilson – volume: 37 start-page: 1335 year: 2001 ident: 3243_CR6 publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(01)01138-X contributor: fullname: W.B. Hillegass – volume: 63 start-page: 171 year: 2004 ident: 3243_CR12 publication-title: Catheter Cardiovasc Interv doi: 10.1002/ccd.20149 contributor: fullname: H.J. Wang – volume: 10 start-page: 5 year: 2008 ident: 3243_CR10 publication-title: Acute Card Care doi: 10.1080/17482940701744318 contributor: fullname: K.W. Lee – volume: 6 start-page: 125 year: 2008 ident: 3243_CR2 publication-title: Cardiovasc Hematol Agents Med Chem doi: 10.2174/187152508783955079 contributor: fullname: S.J. Valero |
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The no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The... The no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The incidence of... BACKGROUNDThe no-reflow phenomenon is characterized by an inadequate myocardial tissue perfusion in the presence of a patent epicardial coronary artery. The... |
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| SubjectTerms | Angioplasty, Balloon, Coronary - methods Cardiology Coronary Angiography Coronary Artery Bypass Coronary Restenosis - diagnostic imaging Coronary Restenosis - therapy Coronary Vessels - drug effects Female Graft Occlusion, Vascular - diagnostic imaging Graft Occlusion, Vascular - therapy Humans Injections Internal Medicine Male Medicine Medicine & Public Health Middle Aged Myocardial Infarction - diagnostic imaging Myocardial Infarction - therapy Nitroprusside - administration & dosage No-Reflow Phenomenon - diagnostic imaging No-Reflow Phenomenon - drug therapy Postoperative Complications - diagnostic imaging Postoperative Complications - therapy Vasodilator Agents - administration & dosage Veins - transplantation |
| Title | The Use of Intracoronary Sodium Nitroprusside to Treat No-Reflow after Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction |
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