Attenuation of the no-reflow phenomenon after coronary angioplasty for acute myocardial infarction with intracoronary papaverine

• Published in: The American heart journal Vol. 132; no. 5; pp. 959 - 963
• Main Authors: Ishihara, Masaharu, Sato, Hikaru, Tateishi, Hironobu, Kawagoe, Takuji, Shimatani, Yuji, Kurisu, Satoshi, Sakai, Kazuko
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.11.1996
• Subjects: Adult; Aged; Angioplasty, Balloon, Coronary; Coronary Angiography; Coronary Circulation - drug effects; Female; Heart - physiology; Humans; Male; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Papaverine - pharmacology; Regional Blood Flow; Vasodilator Agents - pharmacology
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(96)90005-8

The no-reflow phenomenon is observed as reduction of coronary blood flow on the angiograms (angiographic no-reflow) after immediate percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI). To assess whether a potent coronary microvascular dilator—papaverine—could attenuate the no-reflow phenomenon, nine patients with AMI who were found to have angiographic no-reflow after PTCA were studied. Angiographic no-reflow was defined as the Thrombolysis in Myocardial Infarction flow grade 1 or 2 without any mechanical obstructions in the epicardial artery. A bolus dose of 10 mg of intracoronary papaverine was administered, and the flow grade was again evaluated. Intracoronary papaverine caused a significant improvement of the flow grade ( p = 0.0152). The number of cineframes that were required for the contrast medium to pass two selected landmarks on the angiograms also significantly decreased (41 ± 17 frames to 18 ± 8 frames, p = 0.0039). Thus intracoronary papaverine attenuated angiographic no-reflow that occurred after PTCA for AMI.