J Transcat Intervent.2019;27:eA20180005.
Refractory no-reflow phenomenon. Keep calm and watchful waiting!
Risk awareness of no-reflow is mandatory, especially in patients with cardiovascular risk factors, long door-to-balloon time, and in the presence of angiographic evidence of a large thrombus burden. Some preventive strategies have been described. Nevertheless, in clinical practice, is difficult to avoid no-reflow. Interventional cardiologists have no guidelines or recommendations for this situation. We suggest that a conservative management with dual antiplatelet therapy and slow intravenous infusion of nitroglycerine over 12 to 24 hours and abciximab, followed by deferred re-evaluation days later could be a good strategy for refractory no-reflow.