No-Reflow and Atherectomy

No-reflow is when blood flow through a coronary artery is decreased, without any evidence of common causes. Certain surgeries carry a risk of no-flow, and an atherectomy is one of them. Because there is decreased blood flow, no-reflow can cause a heart attack. If someone experiences no-flow and an atherectomy is the cause, a pacemaker may be used and removed before the surgery is over.

No-Reflow and Atherectomy: An Overview

There are many reasons for decreased blood flow through a coronary artery, such as:
 
 
  • Blockage
  • Blood clots
  • Spasm of the blood vessel.
 
These can occur during or after an atherectomy. However, sometimes you can experience a decrease in blood flow through a coronary artery without evidence of these more common causes. This is called no-reflow.
 
The exact reason that this complication occurs is unknown. Just like other complications that result in a decrease in blood flow to the heart muscle, no-reflow can result in a heart attack.
 
Your doctor has several options to treat no-reflow; yet the success of these treatments varies with the individual. No-reflow may require your doctor to put in a temporary pacemaker. A pacemaker is a commonly used life-saving device that tells your heart when to beat. The pacemaker is usually removed before the atherectomy is over. Pacemaker wires may cause a higher risk of infection, and may tear a part of the heart.
 
It is also possible that an intra-aortic balloon pump may need to be placed in the event that the condition cannot be treated with medication. This pump simply increases the pressure in your arteries so that blood can be pumped more effectively.
 

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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD
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