Invasive assessment of coronary microvascular obstruction
De Maria GL., Banning AP.
© 2018 Elsevier Inc. All rights reserved. Percutaneous coronary intervention is currently the gold standard treatment for patients with myocardial infarction. However, restoration of patency of the infarct-related artery does not always translate into optimal myocardial reperfusion, a condition known as slow/no reflow, typically associated to poor long-term clinical outcome. Microvascular injury (MVI) is the pathophysiological background underlying slow/no reflow. The first step to successful management of such condition is represented by early identification and diagnosis of MVI. Different techniques are available in such regard. In the current chapter, we aim to deal with the invasive indices for the assessment of microvascular obstruction in the catheterization laboratory, reporting in details the main aspects, the pros and the cons of angiography-derived, intracoronary-Doppler-derived, and thermodilution-derived indices.