Digital subtraction angiography - This is a quantitative approach which estimates the rate of brightness and the rate of growth of the blush.The CCFC has been shown to correlate with both the TMPG and the MBG. The difference between these two values of the frame counts is defined as the CCFC. In order to calculate the CCFC, Frame 'O' represents the first frame in which the contrast medium is seen to be cleared from the ostium of the infarcted artery and the 'last frame' represents the point when the contrast begins to be cleared from the standardized distal landmark proposed by the TIMI Group. Coronary clearance frame count (CCFC) - This is a quantitative method designed to remove the observer bias associated with the prior methods.Both of these methods are subjected, therefore, they are affected by observer bias. TMPG focuses on the rate of clearance of the contrast opacity as well as the degree of intensity of the contrast opacity in the infarcted area when compared with the non-infarcted areas, while MBG focuses on the latter.
This can be assessed directly by using myocardial blush grade (MBG), TIMI Myocardial Perfusion Grade (TMPG), coronary clearance frame count or digital subtraction angiography or can be assessed indirectly by using the corrected TIMI frame counts. Perfusion of the myocardium has been shown to be an independent predictor of outcome.
Outlined with a yellow dashed line is the pathway that the dye would have filled in case the stenosis was absent. Image is the flow of the dye which completely stops at the level of the stenosis. Shown above is an animated image and a static image depicting TIMI flow grade 0 in the RCA. Although this method was associated with improved clinical outcomes, however, it is now understood that restoration of epicardial blood flow does not necessarily improve perfusion at the tissue level or microvascular perfusion. Ī more accurate technique to evaluate epicardial coronary blood flow is by using the number of angiographic frames required for a dye to reach a specified distal segment in the coronary artery, this was referred to as the TIMI frame count (TFC) by Gibson et al in 1999. For example, the majority of TFG 3 are located in the right coronary artery, while the majority of TFG 2 are observed in the left anterior descending artery. Although TFG has been associated with clinical outcomes in the past, its use has been limited by many confounding variables such as the location of infarct. This method measures the coronary artery clearance of the injected radiographic dye. This involves the use of Thrombolysis in Myocardial Infarction (TIMI) blood flow grades (TFG) to evaluate epicardial coronary blood flow in acute coronary syndromes. Ayokunle Olubaniyi, M.B,B.S Overview Assessment of Epicardial Blood Flow List of terms related to No-reflow phenomenon CTĮditor-In-Chief: C. No-reflow phenomenon CT in the Marketplace Patient Handouts on No-reflow phenomenon CTĭirections to Hospitals Treating No-reflow phenomenon CTĬauses & Risk Factors for No-reflow phenomenon CTĭiagnostic studies for No-reflow phenomenon CT Patient resources on No-reflow phenomenon CTĭiscussion groups on No-reflow phenomenon CT US National Guidelines Clearinghouse on No-reflow phenomenon CTīe alerted to news on No-reflow phenomenon CT Ongoing Trials on No-reflow phenomenon CT at Clinical Ĭlinical Trials on No-reflow phenomenon CT at Google Podcasts & MP3s on No-reflow phenomenon CTĬochrane Collaboration on No-reflow phenomenon CT Powerpoint slides on No-reflow phenomenon CT Review articles on No-reflow phenomenon CTĪrticles on No-reflow phenomenon CT in N Eng J Med, Lancet, BMJ Most cited articles on No-reflow phenomenon CT
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