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The Open Artery Hypothesis: Past, Present, and Future

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Abstract

The survival benefit following a reperfusion strategy, be it pharmacologic or mechanical, appears to be due to both full and early reperfusion. While the TIMI Flow Grade classification scheme has been a useful tool to assess coronary blood flow in acute syndromes, it has several limitations. A newer method of assessing coronary blood flow called the Corrected TIMI Frame Count method has the following advantages: (1) it is a continuous quantitative variable rather than a categorical qualitative variable; (2) the flow in the non-culprit artery is not assumed to be normal as it is in the assessment of TIMI Grade 3 Flow; (3) there is simplified reporting of reperfusion efficacy through the use of a single number instead of expressing the data in 2 to 4 categories; (4) because a single number rather than 4 categories is used to report the data, there is more efficient use of the dataset by increasing the statistical power; and finally (5) coronary flow can be expressed in intuitive terms (e.g. time or cm/sec for strategy A versus time or cm/sec for strategy B). This paper reviews the history of the open artery hypothesis and recent advances in the field.

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  1. Cardiovascular Division of the Department of Medicine, the West Roxbury Veteran's Administration & Brigham and Women's Hospitals, Harvard Medical School, Boston, Massachusetts

    Mukesh Goel, J. Theodore Dodge Jr., Michael Rizzo, Christine McLean, Kathryn A. Ryan, William L. Daley, Christopher P. Cannon & C. Michael Gibson

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  1. Mukesh Goel
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  2. J. Theodore Dodge Jr.
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Goel, M., Dodge, J.T., Rizzo, M. et al. The Open Artery Hypothesis: Past, Present, and Future. J Thromb Thrombolysis 5, 101–112 (1998). https://doi.org/10.1023/A:1008817810451

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