Jr. Sherman et al., DISTAL VESSEL PULLBACK ANGIOGRAPHY AND PRESSURE-GRADIENT MEASUREMENT - AN INNOVATIVE DIAGNOSTIC-APPROACH TO EVALUATE THE NO-REFLOW PHENOMENON, Catheterization and cardiovascular diagnosis, 39(1), 1996, pp. 1-6
The angiographic appearance of ''no-reflow'' in saphenous vein grafts
or native coronary arteries has been described following administratio
n of thrombolytic therapy or performance of percutaneous transluminal
coronary angioplasty or atherectomy. Apparent occlusion may represent
spasm, dissection, thrombosis, or competitive collateral circulation,
all of which must be excluded to make the diagnosis of ''no-reflow.''
We describe an innovative approach to the diagnostic dilemma created b
y the appearance of ''no-reflow'' at coronary angiography. Pressure gr
adient measurement with distal vessel pull-back (retrograde) angiograp
hy provides maximal information regarding the severity of disease and
the etiology of ''no-reflow,'' while exposing both the patient and ang
iographer to less risk compared to standard strategies. (C) 1996 Wiley
-Liss, Inc.