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| __NOTOC__
| | #redirect[[Abrupt closure]] |
| {{PCI}}
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| '''Editors-In-Chief''': Alexandra Almonacid M.D. [mailto:aalmonacid@partners.org], Jeffrey J. popma M.D. [mailto:jpopma@partners.org]
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| ==Overview==
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| Abrupt closure during coronary intervention is defined as an abrupt cessation of coronary flow to TIMI 0 or 1.
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| ==Abrupt Closure==
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| ===Incidence===
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| Occurs during 3-5% of balloon angioplasty procedures. Its incidence has been markedly reduced with the availability of coronary stents (1).
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| ===Etiology===
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| Abrupt closure may be due to coronary dissection, embolization, or thrombus formation within the vessel. | |
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| ====Factors Associated with Abrupt Closure====
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| *Clinical: unstable angina, female, AMI, chronic renal failure
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| *Angiographic: Intraluminal thrombus, ACC/AHA score, multivessel disease, long lesions, >45 degree angulation, branch points, proximal tortuosity, ostial RCA, degenerated SVGs, prestenosis >90%, intimal dissections
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| ===Treatment===
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| ====Stent Use in Abrupt Closure====
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| *Gianturco-Roubin stent improves lumen size and reduced MACE
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| *PS stent improves outcome: mortality 1.3%, MI 4%, 1% CABG
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| *ACS Multi-Link: mortality 1.4%, MI 2.9%
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| *Mostly associated with subacute stent thrombosis
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| *Rx: maintain flow, complete coverage
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| ===Prognosis===
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| ====Factors Predicting Mortality after Abrupt Closure====
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| *% myocardium at risk
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| *LM and multivessel disease
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| *CHF, UAP
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| *Target vessels supplies collaterals
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| *> age 65 years
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| *Chronic renal failure
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| *Female gender
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| *Diabetes
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| ==References==
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| {{reflist|2}}
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| #ref1 PMID 11870931
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| [[Category:Up-To-Date]]
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| [[Category:Up-To-Date cardiology]]
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| [[Category:Cardiology]]
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