A Comparative Study of Two Methods of Thrombus Aspiration and Adenosine Injection on No-Reflow Phenomenon

Introduction- Lack of myocardial reperfusion after an ischemic period despite reperfusion therapy is called the no-reflow phenomenon.This study aimed to compare no-reflow phenomenon outcomes (ECG and enzyme changes) in Adenosine injection and thrombosis aspiration methods. Methods- A quasi-experimental study was performed on patients undergoing percutaneous coronary intervention in three selected Tehran hospitals (April 2011 to June 2012). Forty patients (24 men and 16 women) were included in the study. ST-segment elevation and cardiac enzymes changes were compared in Adenosine injection and thrombus aspiration in patients with the noreflow phenomenon 24 hours after percutaneous coronary intervention. Findings- The Adenosine and thrombus aspiration groups did not show significant differences in cardiac enzyme changes (positive troponin, or CKMB elevation). Also, the Adenosine and thrombus aspiration groups did not show significant difference in ST-segment elevation (P > 0.05). Conclusions- This study confirms the results of positive restore coronary perfusion in Adenosine infusion and thrombosis aspiration. Now the question is why enzyme and ECG changes have been reported more in the thrombus aspiration method despite the improvement in cardiac perfusion to Adenosine injection? The response seems to be related to more aggressiveness of the thrombus aspiration method, but this explanation should be confirmed by more investigations.