Dawood, M., Elwany, M., Abdelaty, A., Kholeif, A., Elmaghraby, M. (2025). EFFICACY OF INTRACORONARY EPINEPHRINE IN STEMI PATIENTS WITH REFRACTORY CORONARY NO REFLOW DURING PERCUTANOUS CORONARY INTERVENTION .. ALEXMED ePosters, 7(1), 32-33. doi: 10.21608/alexpo.2025.358274.2083
Mostafa Dawood; Mostafa Elwany; Ahmed Ibrahim Abdelaty; Abdelfattah Kholeif; Mohamed Adel Mohamed Elmaghraby. "EFFICACY OF INTRACORONARY EPINEPHRINE IN STEMI PATIENTS WITH REFRACTORY CORONARY NO REFLOW DURING PERCUTANOUS CORONARY INTERVENTION .". ALEXMED ePosters, 7, 1, 2025, 32-33. doi: 10.21608/alexpo.2025.358274.2083
Dawood, M., Elwany, M., Abdelaty, A., Kholeif, A., Elmaghraby, M. (2025). 'EFFICACY OF INTRACORONARY EPINEPHRINE IN STEMI PATIENTS WITH REFRACTORY CORONARY NO REFLOW DURING PERCUTANOUS CORONARY INTERVENTION .', ALEXMED ePosters, 7(1), pp. 32-33. doi: 10.21608/alexpo.2025.358274.2083
Dawood, M., Elwany, M., Abdelaty, A., Kholeif, A., Elmaghraby, M. EFFICACY OF INTRACORONARY EPINEPHRINE IN STEMI PATIENTS WITH REFRACTORY CORONARY NO REFLOW DURING PERCUTANOUS CORONARY INTERVENTION .. ALEXMED ePosters, 2025; 7(1): 32-33. doi: 10.21608/alexpo.2025.358274.2083
EFFICACY OF INTRACORONARY EPINEPHRINE IN STEMI PATIENTS WITH REFRACTORY CORONARY NO REFLOW DURING PERCUTANOUS CORONARY INTERVENTION .
1Department of Cardiology and Angiology, Faculty of Medicine, Alexandria University
2Cardiology and Angiology Departments, Alexandria University, Faculty of Medicine, Egypt
Abstract
The no-reflow phenomenon is a common complication during primary percutaneous coronary intervention. The frequency of no reflow may be encountered in up to 50% of primary percutaneous coronary intervention cases but in elective PCI cases, it is around 0.6-5 %. Because of high resistance secondary to microvascular obstruction (MVO), no-reflow results in impaired myocardial perfusion that is associated with severe chest pain, cardiogenic shock with hypotension, life threatening arrhythmias either bradyarrythmia or tachyarrythmia, hemodynamic collapse, MI, congestive heart failure leading to pulmonary edema , and death.
Aim of the Work: The aim of the study was to assess efficacy and safety of intracoronary epinephrine in STEMI patients with refractory coronary no-reflow during primary PCI. The efficacy was determined by improvement of TIMI flow and myocardial blush grade.
Subjects And Methods: The study was a single – centered, prospective and observational study. It included one hundred patients with no reflow during PPCI in Alexandria Main University Hospital. All of the patients received intracoronary verapamil (dose: 100-500 µg bolus (max 1 mg)). If no reflow persists, adrenaline were given IC (dose: 80-100 µg bolus). Adrenalin was repeated if no reflow persists up to 3 boluses. Inclusion criteria: STEMI at presentation. Admitted for PPCI with refractory no reflow in the culprit vessel. Exclusion criteria:Coronary spasm and dissection. Closed angle glaucoma. Known history of drug hypersensitivity. Valvular heart disease. Congenital heart disease. Contraindications to use aspirin or clopedogril. Cardiomyopathy. Pericarditis or myocarditis.
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