177 © Springer-Verlag London 2016 A. Lindsay et al. (eds.), Complications of Percutaneous Coronary Intervention, DOI 10.1007/978-1-4471-4959-0_22 I.D. Kilic, MD Department of Cardiology, Pamakkale University Hospital, Denizle, Turkey e-mail: idogukilic@yahoo.com R. Serdoz, MD Department of Cardiology, Royal Brompton Hospital, London, UK e-mail: robertaserdoz@yahoo.it C. Di Mario, MD, PhD Cardiovascular Biomedical Research Unit, National Institute of Health Research, Royal Brompton Hospital & NHLI Imperial College, London, UK T. Kabir, MD (*) Department of Cardiology, Harefield Hospital, Royal Brompton & Harefield NHS Trust, Harefield, Middlesex, UK 22 No-Reflow Phenomenon Ismail Dogu Kilic, Roberta Serdoz, Carlo Di Mario, and Tito Kabir Abstract No-reflow describes a condition in which myocardial blood flow is reduced after a coronary intervention, despite angiographically patent coronary arteries. It is diagnosed by reduced epicardial blood flow in the presence of a seemingly patent coronary artery, however its incidence is thought to be higher than is estimated by clinical judgment or angiography alone. Various manoeuvres or pharmaco- logical agents can be used in the prevention or treatment of no reflow, however there is currently no clear guideline as to which method(s) are most efficacious. Keywords No reflow phenomenon • Myocardial perfusion • Ischemia- reperfusion injury • Coronary intervention • Acute myocardial infarction