Pathophysiology, prevention, and management of coronary microvascular obstruction

No-reflow observed post-PCI, after excluding residual epicardial stenosis, indicates poor microvascular perfusion and necessitates urgent management

Identifying high-risk patients and implementing early targeted interventions are essential to improving outcomes

Intracoronary adenosine and nitroprusside have shown unclear benefit in improving microvascular flow

Ischaemic postconditioning, intracoronary supersaturated oxygen, stent-retriever thrombectomy and mechanical LV unloading have shown promise but require validation in large-scale trials