Infarct related artery

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Coronary Angiography

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Epicardial Flow & Myocardial Perfusion

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Lesion Complexity

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Preprocedural Lesion Morphology

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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
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Left ventriculography

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Infarct related artery or culprit artery refers to a coronary artery that is blocked or stenosed by atheroma and thrombosis, and responsible for an acute coronary syndrome. Although, there is one culprit artery in majority of cases, there may infrequently (approximately 1% in angioscopy studies) be multiple culprit arteries present in acute coronary syndromes. [1] [2] [3]

Diagnosis of the Infarct Related Artery

Three diagnostic tools are useful in the identification of the culprit artery:

  • Coronary angiography: The presence of an intracoronary filling defect to suggest coronary thrombosis or the presence of a coronary ulcer aids in the identification of the culprit artery. The presence of slow flow in the artery may suggests that it is the culprit artery. However, in the presence of both STEMI and NSTEMI, flow in the non-culprit artery may be slowed as well.
  • The 12 lead EKG or 80 lead EKG may aid in identification of the culprit artery.
  • Left ventriculography may demonstrate a wall motion abnormality which may also assist in the identification of the culprit artery.

References

  1. Hurst's the Heart, Fuster V, 12th ed. 2008, ISBN 978-0-07-149928-6
  2. Willerson JT, Cardiovascular Medicine, 3rd ed., 2007, ISBN 978-1-84628-188-4
  3. Gibson CM, Has My Patient Achieved Adequate Myocardial Reperfusion? Circulation, August 5, 2003; 108(5): 504 - 507

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