Coronary Angiography Home General Principles Overview Historical Perspective Contraindications Appropriate Use Criteria for Revascularization Complications Technique Film Quality Anatomy & Projection Angles Normal Anatomy Coronary arteries Dominance Right System Left System Left Main Left Anterior Descending Circumflex Median Ramus Anatomic Variants Separate Ostia Anomalous Origins Case Example Fistula Projection Angles Standard Views Left Coronary Artery Right Coronary Artery Epicardial Flow & Myocardial Perfusion Epicardial Flow TIMI Frame Count TIMI Flow Grade TIMI Grade 0 Flow TIMI Grade 1 Flow TIMI Grade 2 Flow TIMI Grade 3 Flow TIMI Grade 4 Flow Pulsatile Flow Deceleration Myocardial Perfusion TIMI Myocardial Perfusion Grade TMP Grade 0 TMP Grade 0.5 TMP Grade 1 TMP Grade 2 TMP Grade 3 Lesion Complexity ACC/AHA Lesion-Specific Classification of the Primary Target Stenosis Preprocedural Lesion Morphology Eccentricity Irregularity Ulceration Intimal Flap Aneurysm Sawtooth Pattern Length Ostial location Angulation Proximal tortuosity Degenerated SVG Calcification Total occlusion Coronary Artery Thrombus TIMI Thrombus Grade TIMI Thrombus Grade 0 TIMI Thrombus Grade 1 TIMI Thrombus Grade 2 TIMI Thrombus Grade 3 TIMI Thrombus Grade 4 TIMI Thrombus Grade 5 TIMI Thrombus Grade 6 Lesion Morphology Quantitative Coronary Angiography Definitions of Preprocedural Lesion Morphology Irregular Lesion Disease Extent Arterial Foreshortening Infarct Related Artery Restenosis Degenerated SVG Collaterals Aneurysm Bifurcation Trifurcation Ulceration Left ventriculography Technique Quantification of LV Function Quantification of Mitral Regurgitation Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Synonyms and keywords: TIMI 0, TIMI 0 flow, TIMI 0 flow grade, TFG 0, TFG0 ## Overview[edit | edit source] TIMI Grade 0 flow is defined as no perfusion. There is no antegrade flow beyond the point of occlusion.[1] [2] [3] ## Example[edit | edit source] Shown below are an animated image and a static image depicting TIMI flow grade 0 in the RCA. Outlined in blue in the second image is the flow of the dye which completely stops at the level of the stenosis. Outlined with a yellow dashed line is the pathway that the dye would have filled in case the stenosis was absent. ## Additional Examples[edit | edit source] Click here for other examples of TIMI flow grade 0. ## References[edit | edit source] 1. ↑ Gibson, CM; Ryan, K; Sparano, A; Rizzo, M; Moynihan, J; Kelley, M; Marble, SJ; Dodge, JT; Antman, EM. Methodologic drift in the assessment of TIMI grade 3 flow and its implications with respect to the reporting of angiographic trial results. Am Heart J. 1999;137:1179–1184. PMID 10347349 2. ↑ Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, McCabe CH, Raymond L, Fortin T, Poole WK, Braunwald E. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation. 1996 Mar 1;93(5):879-88. PMID 8598078 3. ↑ Gibson CM, Murphy S, Menown IB, Sequeira RF, Greene R, Van de Werf F, Schweiger MJ, Ghali M, Frey MJ, Ryan KA, Marble SJ, Giugliano RP, Antman EM, Cannon CP, Braunwald E. Determinants of coronary blood flow after thrombolytic administration. TIMI Study Group. Thrombolysis in Myocardial Infarction. J Am Coll Cardiol. 1999 Nov 1;34(5):1403-12. PMID 10551685 * v * t * e Coronary Angiography Coronary Anatomy| Normal coronary anatomy • Anomalous origins of coronary arteries (Left coronary artery • Right coronary artery) • Congenital abnormalities of coronary arteries • Coronary artery segments • Cinefilm frame speed • Coronary artery dominance (Left dominance • Right dominance • Co-dominance) TIMI Flow Grade| TIMI flow grade 0 • TIMI flow grade 1 • TIMI flow grade 2 • TIMI flow grade 3 TIMI Frame Count| TFC for SVG • TIMI Myocardial Frame Count • Washout TIMI Frame Count TIMI Myocardial Perfusion Grade| TIMI MPG 0 • TIMI MPG 1 • TIMI MPG 2 • TIMI MPG 3 Thrombus Grading| Thrombus Grade 0 • Thrombus Grade 1 • Thrombus Grade 2 • Thrombus Grade 3 • Thrombus Grade 4 • Thrombus Grade 5 • Thrombus Grade 6 Lesion Complexity| Type A • Type B1 • Type B2 • Type C Dissection Classification| Type A • Type B • Type C • Type D • Type E • Type F Coronary Collaterals| Grade 0 • Grade 1 • Grade 2 • Grade 3 • Rentrop and Cohen’s Collateral Classification Lesion Morphology| Myocardial bridge •Definitions of Preprocedural Lesion Morphology • Luminal irregularities • Disease extent • Arterial foreshortening • Infarct related artery (Culprit lesion) • Reocclusion • Restenosis • Degenerated saphenous vein graft • Coronary artery fistula Angiographic complications| Distal embolization • Coronary spasm • Abrupt closure • Side branch loss • Slow flow • No-reflow • Pulsatile flow • Flow deceleration • Ectasia • Intimal flap • Staining • Performing Coronary Angiography| Patient preparation • Catheter selection • Standard angiographic views • High risk groups • Patients with special need • Access site closure (Manual compression • Assisted compression • Closure devices) • Quantitative Coronary Angiography (QCA)| Minimal lumen diameter • Percent stenosis • Reference diameter • Lesion length • Residual stenosis • Average reference segment diameter • Plaque area • Plaque volume • Contrast Media| High-osmolar contrast media • Iso-osmolar contrast media • Low-osmolar contrast media Left Ventriculography & Aortography| Ejection fraction • Aortography • Quantitative Left Ventricular Analysis (LAO projection • RAO projection • LVA) • Left Ventricular Wall Motion Analysis (Normokinesia • Hypokinesia • Akinesia • Dyskinesia • Aneurysm) • Evaluation of mitral regurgitation • Evaluation of aortic regurgitation Right Heart Catheterization| Pressure waveforms (Right atrial pressure • Rirght ventricular pressure • Pulmonary artery pressure • Pulmonary artery wedge-pressure) • Endomyocardial biopsy Complications| Access site complications • Dumping • Contrast hypersensitivity • Contrast induced nephropathy • Hypotension • Hypertension • Dissection • Vessel perforation • Acute myocardial infarction • Ventricular fibrillation • Cardiac arrest • Stroke • ASD • VSD • Pulmonary emboli • Myocardial rupture • Peripheral arterial emboli • Radiation injury Template:WikiDoc Sources *[v]: View this template *[t]: Discuss this template *[e]: Edit this template