TIMI thrombus grade
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Thrombus Grade
The PERFUSE study group developed the following thrombus grading system:[1]
PERFUSE Grade 0
No cineangiographic characteristics of thrombus present.
Grade 1
Hazy, possible thrombus present. Angiography demonstrates characteristics such as reduced contrast density, haziness, irregular lesion contour, or a smooth convex "meniscus" at the site of total occlusion suggestive but not diagnostic of thrombus.
Grade 2
Thrombus present – small size: Definite thrombus with greatest dimensions less than or equal to 1/2 vessel diameter.
Grade 3
Thrombus present – moderate size: Definite thrombus but with greatest linear dimension greater than 1/2 but less than 2 vessel diameters.
Grade 4
Thrombus present – large size: As in Grade 3 but with the largest dimension greater than or equal to 2 vessel diameters.
Grade 5
Recent total occlusion, can involve some collateralization but usually does not involve extensive collateralization, tends to have a “beak” shape and a hazy edge or appearance of distince thrombus.
Grade 6
Chronic total occlusion, usually involving extensive collateralization, tends to have distinct, blunt cut-off/edge and will generally clot up to the nearest proximal side branch.
Natural History, Complications, Prognosis
Angiographically evident thrombus as assessed using the PERFUSE Grade described above is associated with embolization and impaired myocardial perfusion.[2][3]
References
- ↑ 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.
- ↑ 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.