Total coronary occlusion (TCO) is characterized by an obstruction with an estimated duration of more than 3 months and is present in approximately 15–18% of all coronary angiographies performed. Clinical manifestations can range from asymptomatic, through stable angina, to varying degrees of ventricular dysfunction. This mainly depends on the degree of collateral circulation. If it is poor, it may compromise the viability of myocytes and associate with various degrees of necrosis and/or hibernating myocardium. In the presence of well-developed collaterals […]

Abstract Coronary artery fistula is a rare anatomic abnormality of the coronary arteries that affects 0.002% of the general population and represents 14% of all anomalies of coronary arteries. Its clinical relevance focuses mainly on the mechanism of the coronary steal phenomenon, causing myocardial functional ischemia, even in the absence of stenosis; therefore, angina and effort dyspnea are common symptoms. The suggested diagnostic approach is driven by patients’ symptoms, and it consists of a number of instrumental examinations like ECG, […]

From its inception, indirect coronary flow assessment by coronary angiography (CAG) has been reported in every catheterization laboratory note as it is regarded a prognostic tool particularly in the context of primary percutaneous coronary intervention. Thrombolysis in myocardial infarction (TIMI) flow grade system and, somewhat less often, corrected TIMI Frame Count (CTFC) are the two most commonly used scores to reflect the status of coronary blood flow (CBF). In this issue, Lopez-Hidalgo and Eblen-Zajjur report a new approach of quantitative […]