What are the potential complications of primary PCI?
Potential complications of primary PCI include problems with the arterial access site; adverse reactions to volume loading, contrast medium, and antithrombotic medications; technical complications; and reperfusion events. The no- reflow phenomenon refers to suboptimal myocardial perfu- sion despite restoration of epicardial flow in the infarct artery and has been attributed to the combined effects of inflam- mation, endothelial injury, edema, atheroembolization, vasospasm, and myocyte reperfusion injury. No-reflow is associated with a reduced survival rate. Treatment and prevention strategies have included use of the GP IIb/IIIa antagonist abciximab, vasodilators (nitroprusside, vera- pamil, adenosine), and inhibitors of various metabolic pathways (nicorandil, pexelizumab), albeit without consistent effect.