Abrupt closure during coronary intervention

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Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1], Alexandra Almonacid M.D. [2], Jeffrey J. Popma M.D. [3]; Associate Editor(s)-in-Chief: Hardik Patel, M.D., Sapan Patel M.B.B.S

Overview

Abrupt closure during coronary intervention is defined as an abrupt cessation of coronary flow to TIMI grade 0 or 1 flow in an artery in which PTCA was attempted where there had previously been TIMI grade 2 or 3 flow prior to the procedure. It occurs primarily due to acute coronary dissection, thrombosis, or, most often, a combination of both during coronary intervention.

Definition

Abrupt closure during coronary intervention is defined as an abrupt cessation of coronary flow to TIMI grade 0 or 1 flow in an artery in which PTCA was attempted where there had previously been TIMI grade 2 or 3 flow prior to the procedure. If TIMI flow grade 1 was present prior to dilation, then the development of TIMI flow grade 0 will constitute abrupt closure.

Classification

Abrupt closure can be classified as sustained or transient:

Sustained abrupt closure: Abrupt closure that has been present when the patient left the cardiac catheterization laboratory.
Transient abrupt closure: Abrupt closure that has been treated with restoration of coronary flow to TIMI flow grade 2 or 3 before the patient left the cardiac catheterization laboratory.

Causes

Abrupt closure occurs primarily as a result of acute coronary dissection, thrombosis, or, most often, a combination of both during coronary intervention. It may also occur as a result of embolization.