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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 [[interventional cardiology|coronary intervention]] is defined as an abrupt cessation of [[coronary blood flow|coronary flow]] to [[TIMI flow grade 0|TIMI 0]] or [[TIMI flow grade 1|1]].
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| ==Abrupt Closure==
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| ===Incidence===
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| It occurs during 3-5% of balloon angioplasty procedures. Its [[incidence]] has been markedly reduced with the availability of [[coronary stent]]s.
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| ===Causes===
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| Abrupt closure may be due to [[coronary dissection]], [[embolization]], or [[thrombus]] formation within the [[vessel]]. | |
| ====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 coronary artery disease|multivessel disease]], long [[lesion]]s, >45 degree angulation, branch points, [[proximal]] [[tortuosity]], ostial [[RCA]], degenerated [[SVG]]s, pre[[stenosis]] >90%, [[intimal]] [[dissection]]s
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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 coronary artery disease|multivessel disease]]
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| *[[CHF]], [[UAP]]
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| *Target [[vessel]]s supplies [[collateral]]s
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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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| ===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|stent thrombosis]]
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| *Rx: maintain flow, complete coverage.
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| ==References==
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| {{reflist|2}}
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| #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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