The No-Reflow Phenomenon

The no-reflow phenomenon following a severe ischemic episode was first described in the brain [1] and subsequently has been observed in other organs including the kidney [2] and the heart [3]. In the brain edema and increased intracranial pressure inside of the rigid skull have been shown to limit reflow. Likewise, the kidney is encapsulated in a fibrous sheath, and reflow may be limited by extrinsic compression. However, the heart has no constricting external capsule, and no-reflow must occur by mechanisms other than extrinsic compression of the organ.