Intracoronary epinephrine in the treatment of refractory no-reflow after primary percutaneous coronary intervention: a retrospective study

摘要: Background: Despite the advances in medical and interventional treatment modalities, some patients develop epicardial coronary artery reperfusion but not myocardial after primary percutaneous intervention (PCI), known as no-reflow. The goal of this study was to evaluate safety efficacy intracoronary epinephrine reversing refractory no-reflow during PCI. Methods: A total 248 consecutive STEMI who had undergone PCI were retrospectively evaluated. Among those, 12 which received treat a phenomenon Refractory defined persistent TIMI flow grade (TFG) ≤2 despite administration at least one other pharmacologic intervention. TFG, frame count (TFC), perfusion (TMPG) recorded before administration. Results: mean 333±123 mcg administered. No-reflow successfully reversed with complete restoration 3 9 (75%). TFG improved from 1.33±0.49 prior 2.66±0.65 (p<0.001). There an improvement 11 (93%) patients, two 5 (42%) cases. TFC decreased 56±10 time 19±11 reduction TMPG 0.83 ± 0.71 2.58 0.66 detected bolus (p < 0.001). Epinephrine well tolerated without serious adverse hemodynamic or chronotropic effects. Intracoronary resulted significant tolerable increase heart rate (68 13 95 16 beats/min; p 0.001) systolic blood pressure (94 18 140 20; Hypotension associated developed patients. During procedure, intra-aortic balloon pump counterpulsation required (17%) transvenous pacing 2 cases, both (8%) One patient died all therapeutic measures. Conclusion: may become effective alternative suffering following