What is no reflow after PCI?
What is no reflow after PCI?
Introduction and Definition “Reperfusion no reflow” occurs after primary percutaneous coronary intervention (PCI) for reperfusion of an infarct artery in the setting of acute myocardial infarction (AMI) and may be asymptomatic or may present clinically with continued chest pain and ST-segment elevation.
How do you treat no reflow?
Intracoronary nitroprusside at doses of 50 to 300 μg is quite effective in the treatment of no-reflow. When injected distally in the coronary artery, it will have negligible systemic effect on the blood pressure but will induce marked improvement in coronary flow and myocardial tissue blush.
What is myocardial blush?
Myocardial blush grade (MBG) is a simple visual angiographic assessment of myocardial perfusion in the infarct area, as first described by van’t Hof et al7; MBG seems to be of additional value, especially in patients with restored epicardial blood flow because MBG reflects the extent of damage of the microvascular bed.
What is TIMI flow grade?
The TIMI flow grading system is a widely used method of grading coronary flow. While the TMPG that was invented by C. Michael Gibson M.S., M.D. assesses perfusion in the capillary bed at the tissue level, the TIMI flow grade is used to assess epicardial coronary blood flow.
What is code stemi?
Code STEMI is a program designed to help medical professionals recognize heart attacks and immediately activate a protocol that ensures patients receive lifesaving care as quickly as possible. At NHRMC, we focus on reducing heart attack treatment times to give the best chance for a full recovery.
What is contraction band necrosis?
Contraction band necrosis is a type of uncontrolled cell death (necrosis) unique to cardiac myocytes and thought to arise in reperfusion from hypercontraction, which results in sarcolemmal rupture.
What is coronary slow flow?
Coronary slow-flow phenomenon (CSFP) is an angiographic phenomenon characterised by the slow passage of contrast in the absence of obstructive coronary artery disease. Treatment and prognosis are obscure. Here find an outline of management of CSFP within the perimeter of available evidence.
How is TIMI frame count calculated?
TIMI frame count is defined as the number of cineframes required for contrast to reach a standardized distal coronary landmark in the culprit vessel. The number is expressed based upon a cinefilming rate of 30 frames/second. Thus, a frame count of 30 would mean that 1 second was required for dye to traverse the artery.
What does TIMI 2 flow mean?
The TIMI (Thrombolysis in Myocardial Infarction) flow grade is a widely used method for the assessment of coronary artery flow in acute coronary syndromes. Flow in coronary arteries is classified as grade 0 (no flow), grade 1 (penetration without perfusion), grade 2 (partial perfusion) or grade 3 (complete perfusion).
Which artery is blocked in a STEMI?
Anterior STEMI. This type of STEMI usually occurs when a blockage occurs in the left anterior descending (LAD) artery, the largest artery which provides blood flow to the anterior (front) side of your heart.
What is no reflow phenomenon?
No reflow phenomenon is the failure of blood to reperfuse an ischemic area after the physical obstruction has been removed or bypassed.
What is no reflow after an occlusion?
After relief of the occlusion, blood flow to the ischemic tissue may still be impeded, a phenomenon known as no reflow. This article attempts to provide an in-depth understanding of this phenomenon from the laboratory bench to the clinical arena.
What is low reflow in microvasculature?
Diminished flow through the microvasculature compared with normal zones is usually referred to as “low reflow.” 50 An additional mechanism plays a very important role during short-term intervention in acute myocardial infarction.
What is the No-reflow concept?
The no-reflow concept was first suggested in brain ischemia. 2 Brains of rabbits that suffered a brief 2 1/2 minutes of ischemia had normal blood flow when the ischemia was relieved.