Thrombotic lesion: Difference between revisions
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==Overview== | ==Overview== | ||
A thrombus is a blood clot in an intact blood vessel. The presence of | A thrombus is a blood clot in an intact blood vessel. The presence of angiographically evident thrombus (AET) is associated with embolization and impaired myocardial perfusion.<ref name="pmid16847010">{{cite journal| author=Kirtane AJ, Vafai JJ, Murphy SA, Aroesty JM, Sabatine MS, Cannon CP et al.| title=Angiographically evident thrombus following fibrinolytic therapy is associated with impaired myocardial perfusion in STEMI: a CLARITY-TIMI 28 substudy. | journal=Eur Heart J | year= 2006 | volume= 27 | issue= 17 | pages= 2040-5 | pmid=16847010 | doi=10.1093/eurheartj/ehl149 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16847010 }} </ref><ref name="pmid15642554">{{cite journal| author=Kirtane AJ, Weisbord A, Karmpaliotis D, Murphy SA, Giugliano RP, Cannon CP et al.| title=Relation of impaired Thrombolysis In Myocardial Infarction myocardial perfusion grades to residual thrombus following the restoration of epicardial patency in ST-elevation myocardial infarction. | journal=Am J Cardiol | year= 2005 | volume= 95 | issue= 2 | pages= 224-7 | pmid=15642554 | doi=10.1016/j.amjcard.2004.09.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15642554 }} </ref> | ||
==Thrombus Grading== | ==Thrombus Grading== | ||
Click [[Thrombus | In order to more objectively and quantitatively characterize [[thrombus]] on a coronary angiogram, the [http://ww.perfuse.org PERFUSE study group] developed the following [[thrombus]] grading system:<ref name="pmid11382722">{{cite journal| author=Gibson CM, de Lemos JA, Murphy SA, Marble SJ, McCabe CH, Cannon CP et al.| title=Combination therapy with abciximab reduces angiographically evident thrombus in acute myocardial infarction: a TIMI 14 substudy. | journal=Circulation | year= 2001 | volume= 103 | issue= 21 | pages= 2550-4 | pmid=11382722 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11382722 }} </ref> | ||
* [[Thrombus Grade 0 | PERFUSE Grade 0]] | |||
* [[Thrombus Grade 1 | PERFUSE Grade 1]] | |||
* [[Thrombus Grade 2 | PERFUSE Grade 2]] | |||
* [[Thrombus Grade 3 | PERFUSE Grade 3]] | |||
* [[Thrombus Grade 4 | PERFUSE Grade 4]] | |||
* [[Thrombus Grade 5 | PERFUSE Grade 5]] | |||
* [[Thrombus Grade 6 | PERFUSE Grade 6]] | |||
'''Click [[Thrombus Grading|here]] for details about thrombus grading.''' | |||
==Management of the Thrombotic Lesion== | ==Management of the Thrombotic Lesion== | ||
Click [[Management of the thrombotic lesion|here]] for details about the management of | The presence of [[angiogram|angiographically]] apparent [[thrombus]] is associated with poorer outcomes in patients undergoing PCI. [[Thrombus]] often [[embolus|embolizes]] [[distal]]ly and causes [[no reflow]] and associated [[myonecrosis]]. There are two broad strategies to reduce [[thrombus]] burden: mechanical strategies and [[pharmacologic]] strategies. | ||
'''Click [[Management of the thrombotic lesion|here]] for details about the management of thrombotic lesions.''' | |||
==References== | ==References== | ||
Latest revision as of 15:16, 30 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
A thrombus is a blood clot in an intact blood vessel. The presence of angiographically evident thrombus (AET) is associated with embolization and impaired myocardial perfusion.[1][2]
Thrombus Grading
In order to more objectively and quantitatively characterize thrombus on a coronary angiogram, the PERFUSE study group developed the following thrombus grading system:[3]
- PERFUSE Grade 0
- PERFUSE Grade 1
- PERFUSE Grade 2
- PERFUSE Grade 3
- PERFUSE Grade 4
- PERFUSE Grade 5
- PERFUSE Grade 6
Click here for details about thrombus grading.
Management of the Thrombotic Lesion
The presence of angiographically apparent thrombus is associated with poorer outcomes in patients undergoing PCI. Thrombus often embolizes distally and causes no reflow and associated myonecrosis. There are two broad strategies to reduce thrombus burden: mechanical strategies and pharmacologic strategies.
Click here for details about the management of thrombotic lesions.
References
- ↑ Kirtane AJ, Vafai JJ, Murphy SA, Aroesty JM, Sabatine MS, Cannon CP; et al. (2006). "Angiographically evident thrombus following fibrinolytic therapy is associated with impaired myocardial perfusion in STEMI: a CLARITY-TIMI 28 substudy". Eur Heart J. 27 (17): 2040–5. doi:10.1093/eurheartj/ehl149. PMID 16847010.
- ↑ Kirtane AJ, Weisbord A, Karmpaliotis D, Murphy SA, Giugliano RP, Cannon CP; et al. (2005). "Relation of impaired Thrombolysis In Myocardial Infarction myocardial perfusion grades to residual thrombus following the restoration of epicardial patency in ST-elevation myocardial infarction". Am J Cardiol. 95 (2): 224–7. doi:10.1016/j.amjcard.2004.09.007. PMID 15642554.
- ↑ Gibson CM, de Lemos JA, Murphy SA, Marble SJ, McCabe CH, Cannon CP; et al. (2001). "Combination therapy with abciximab reduces angiographically evident thrombus in acute myocardial infarction: a TIMI 14 substudy". Circulation. 103 (21): 2550–4. PMID 11382722.