What strategies are needed to counter the no-reflow phenomenon and limit myocardial reperfusion injury?
Aside from manual aspiration thrombectomy, efforts to counteract the no-reflow phenomenon and to limit myocardial reperfusion injury have had limited success. Remote ischemic preconditioning has engendered little enthusiasm. Trials evaluating the use of antithrombotic and vasodilator agents have been disappointing. New biological, pharmacological, and mechanical strategies should be investigated to facilitate prompt recovery of tissue-level perfusion.