TIMI flow angiographic characteristics collaterals myocardial perfusion stent thrombosis thrombus grade. Aspiration thrombectomy and repeat stenting are associated with improved epicardial coronary artery flow and myocardial perfusion among patients treated for ST. Presence of collateral vessels and low thrombus burden is cardioprotective, while reduced initial TIMI flow is associated with larger infarct size and recurrent ST. The majority of ST patients present with late/very late ST with high thrombus burden and STEMI. At 1-year follow-up, significantly lower risk of repeat ST (HR 0.1 95% CI 0.1,0.2 P < 0.001) among patients with initial TIMI 3 flow at index ST was observed. After multivariable logistic regression, aspiration thrombectomy (AOR 2.6, 95% CI 1.3-5.2) and implantation of a new stent (AOR 2.1, 95% CI 1.1-4.3) were associated with optimal combined epicardial flow and myocardial perfusion. Grade 3: complete perfusion (antegrade flow into the bed distal to the obstruction occurs as promptly as antegrade flow into the bed proximal to the obstruction, and clearance of contrast material from the involved bed is as. A final myocardial perfusion grade of 2-3 was achieved in 79% of patients and was associated with greater use of aspiration thrombectomy (61% vs. TIMI flow grades:6 Grade 0: no perfusion (no antegrade flow beyond the point of occlusion). 25% P = 0.003), glycoprotein IIb/IIIa inhibitors (80% vs. Final TIMI 3 flow was achieved in 90% of patients and was associated with greater use of aspiration thrombectomy (60% vs.

High-risk angiographic findings at presentation included thrombus grade 4-5 (87%), absence of collateral vessels (76%), and reduced initial TIMI 3 flow (90%). In-hospital and 1-year follow-up data were obtained.Īmong 205 cases of angiographic definite ST (60 ± 8 years 87% male), the majority presented with late/very late ST (69%) and STEMI (66%). Demographic, procedural, and angiographic characteristics were recorded. To characterize the prevalence of thrombus burden, collateral vessels to the infarct-related artery, epicardial coronary artery flow, and myocardial perfusion in patients with angiographically confirmed definite stent thrombosis (ST), and to define their relationship with associated treatments and outcomes.Īngiographic characteristics of ST are not well defined.Īll cases of angiographically determined ST at five academic hospitals from 2005 to 2012 were reviewed.

Exertion timi flow 3