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Reperfusion therapy

In myocardial infarction aims to provide early, full and sustained restoration of antegrade flow at the epicardial level and to achieve adequate reperfusion at the myocardial level.

Lack of myocardial reperfusion in the presence of a patent coronary artery is referred to as a no-reflow phenomenon and is attributed to microvascular dysfunction.

No-flow phenomenon in patients with acute myocardial infarction associated with poor outcomes.

Embolization can occur spontaneously or after percutaneous intervention in coronary arteries or venous grafts and have an important role in the no-reflow phenomenon after acute myocardial infarction.

Reperfusion increases free radical production. 

Hypothermia minimizes a patient’s production of deadly free radicals during reperfusion. 

Hypothermia reduces both intracranial pressure and free radical production that improving patient outcome following a blockage of blood flow to the brain.

Cyclosporin at the time of percutaneous coronary intervention (PCI) has been found to deliver a 40 percent reduction in infarct size in patients with reperfusion injury.

Cyclosporin inhibits the actions of cyclophilin D, and protects the mitochondria and cellular energy production from excessive calcium inflows.

Management of reperfusion injury is based on protecting mitochondria.

Cannabidiol (CBD) protects against hepatic ischemia/reperfusion injury by attenuating inflammatory signaling and response of oxidative and nitrative stress, and thereby cell death and tissue injury, but independent from classical CB1 and CB2 receptors.

 

 

 

 

 

 

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