Intracoronary Sodium Nitroprusside is Effective in Treating Slow Flow During Primary PCI. Objective: To study the effect of intracoronary sodium nitroprusside (SNP) for treatment of slow/no-flow phenomenon during primary coronary intervention in patients with acute coronary syndrome Methods: The current study was done in 23patients with acute coronary syndrome, who developed slow flow in their coronary arteries immediately after Primary coronary angioplasty and stenting. Intracoronary sodium nitroprusside was given at 100 microgram per min boluses till good flow was achieved, Blood pressure was maintained by small iv boluses of 0.05 mg of Norepinephrine. Results: Intracoronary SNP improved TIMI Grade 2 vs 3 (p<0.001), Ctfc 30 vs 26 (p<0.001), TMPG 1 vs 2 p<0.001) and MBG by QuBE 8 vs 12 (p<0.002). Conclusions: Higher doses of Intracoronary SNP along with iv boluses of norepinephrine is very useful to improve slow flow in coronaries after primary Pci.