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Slow flow and no reflow remain major unresolved challenges after PCI, particularly in STEMI. Discover our State-of-the-Art review by Salvatore Brugaletta et al exploring the mechanisms, diagnosis, and current treatment strategies #STEMI #PCI #NoReflow #InterventionalCardiology

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EuroIntervention

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16,575 views • 26 days ago •via X (Twitter)

#STEMI#PCI#NoReflow
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My #interventionalcardiology Toolkit 🧰⚙️🪛 No-reflow: distal drug delivery with standard #PCI equipment 🔗 No-reflow is one of the most critical peri-procedural complications and the development of no-reflow can rapidly trigger cardiogenic shock. Emrullah Kiziltunc, Ender Ornek, Adnan Abaci and Mustafa Cetin from 🇹🇷 provide a step-by-step methodology to manage this situation. Reviewed by Manel Sabate. . #CardioEd #Cathlab Chiara De Biase Fadi Sawaya Salvatore Brugaletta
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My #interventionalcardiology Toolkit 🧰⚙️🪛 No-reflow: distal drug delivery with standard #PCI equipment 🔗 No-reflow is one of the most critical peri-procedural complications and the development of no-reflow can rapidly trigger cardiogenic shock. Emrullah Kiziltunc, Ender Ornek, Adnan Abaci and Mustafa Cetin from 🇹🇷 provide a step-by-step methodology to manage this situation. Reviewed by Manel Sabate. . #CardioEd #Cathlab Chiara De Biase Fadi Sawaya Salvatore Brugaletta

PCRonline 🫀

23,888 views • 13 days ago

TIMI Flow: A Key Indicator of Coronary Perfusion TIMI (Thrombolysis in Myocardial Infarction) flow grading is a crucial angiographic tool to assess blood flow in coronary arteries, particularly after an intervention like PCI. 🔹 TIMI 0 (No Flow) – Complete occlusion; no antegrade flow beyond the blockage. 🔹 TIMI 1 (Penetration without Perfusion) – Minimal flow beyond the occlusion but without adequate distal vessel opacification. 🔹 TIMI 2 (Partial Flow) – Delayed but complete filling of the distal vessel; flow is slower than normal. 🔹 TIMI 3 (Normal Flow) – Full, brisk perfusion with normal distal vessel filling, comparable to a non-diseased artery. TIMI 3 flow is the gold standard for successful reperfusion in PCI, improving outcomes in STEMI and other coronary syndromes. #Cardiology #TIMIFlow #CathLab
0:53

TIMI Flow: A Key Indicator of Coronary Perfusion TIMI (Thrombolysis in Myocardial Infarction) flow grading is a crucial angiographic tool to assess blood flow in coronary arteries, particularly after an intervention like PCI. 🔹 TIMI 0 (No Flow) – Complete occlusion; no antegrade flow beyond the blockage. 🔹 TIMI 1 (Penetration without Perfusion) – Minimal flow beyond the occlusion but without adequate distal vessel opacification. 🔹 TIMI 2 (Partial Flow) – Delayed but complete filling of the distal vessel; flow is slower than normal. 🔹 TIMI 3 (Normal Flow) – Full, brisk perfusion with normal distal vessel filling, comparable to a non-diseased artery. TIMI 3 flow is the gold standard for successful reperfusion in PCI, improving outcomes in STEMI and other coronary syndromes. #Cardiology #TIMIFlow #CathLab

CardiovascularCorner

18,450 views • 1 year ago

4 A.M. STEMI call. 45-year-old male with acute anterior STEMI activated through the STEMI pathway. Coronary angiography showed complete thrombotic occlusion of the LAD. Initial ballooning restored flow, and a drug-eluting stent was deployed successfully… or so we thought. Seconds later came one of the true nightmares in interventional cardiology: The stent was physically delivered. Deployment was confirmed. But fluoroscopy showed… no stent in the lesion. The LAD still looked unstented. Immediate full fluoroscopic search of the patient’s body was performed. No lost stent was seen anywhere. The table? Negative. The sheath? Negative. The guiding system inside the body? Negative. Unfortunately, stent boost was unavailable at that moment, and IVUS was not accessible. Multiple vigorous flushes of the guiding catheter failed to reveal the missing stent. At that point, the concern escalated dramatically — embolized stent? Lost in the system? Somewhere unseen? Decision was made to retrieve the entire system and physically inspect everything outside the patient. Still nothing. Finally, as a last attempt, the guiding catheter was carefully cut in small external segments. And there it was. The entire undeployed stent was trapped inside the OUTSIDE portion of the guiding catheter — beyond the fluoroscopy field — firmly stuck despite repeated flushing attempts. The relief in the cath lab at that moment was indescribable. A new stent was then successfully deployed with excellent final angiographic result. Lessons from the night: • Never trust assumptions in the cath lab • Lost stents can hide in unexpected places • Systematic troubleshooting saves lives — and saves operators from panic • Sometimes the solution is not high-tech… but persistence and careful thinking Interventional cardiology continues to humble us. #Cardiology #InterventionalCardiology #STEMI #PCI #CathLab #CoronaryIntervention #LAD #CardioTwitter #MedTwitter #STEMIPathway
2:08

4 A.M. STEMI call. 45-year-old male with acute anterior STEMI activated through the STEMI pathway. Coronary angiography showed complete thrombotic occlusion of the LAD. Initial ballooning restored flow, and a drug-eluting stent was deployed successfully… or so we thought. Seconds later came one of the true nightmares in interventional cardiology: The stent was physically delivered. Deployment was confirmed. But fluoroscopy showed… no stent in the lesion. The LAD still looked unstented. Immediate full fluoroscopic search of the patient’s body was performed. No lost stent was seen anywhere. The table? Negative. The sheath? Negative. The guiding system inside the body? Negative. Unfortunately, stent boost was unavailable at that moment, and IVUS was not accessible. Multiple vigorous flushes of the guiding catheter failed to reveal the missing stent. At that point, the concern escalated dramatically — embolized stent? Lost in the system? Somewhere unseen? Decision was made to retrieve the entire system and physically inspect everything outside the patient. Still nothing. Finally, as a last attempt, the guiding catheter was carefully cut in small external segments. And there it was. The entire undeployed stent was trapped inside the OUTSIDE portion of the guiding catheter — beyond the fluoroscopy field — firmly stuck despite repeated flushing attempts. The relief in the cath lab at that moment was indescribable. A new stent was then successfully deployed with excellent final angiographic result. Lessons from the night: • Never trust assumptions in the cath lab • Lost stents can hide in unexpected places • Systematic troubleshooting saves lives — and saves operators from panic • Sometimes the solution is not high-tech… but persistence and careful thinking Interventional cardiology continues to humble us. #Cardiology #InterventionalCardiology #STEMI #PCI #CathLab #CoronaryIntervention #LAD #CardioTwitter #MedTwitter #STEMIPathway

د. ناصر القحطاني Nasser Alqahtani

20,270 views • 2 months ago

🚨 A 54-year-old smoker presents with a strong cough followed by chest pain. 🔴 Anterior STEMI: SCAD? 🔭Wire appears in and out of the true lumen. 📊 IVUS to confirm? Tom Johnson 🩸 No flow post-ballooning jcspratt Next steps? Ziad Ali PCRonline 🫀 Yader Sandoval Natalia Pinilla
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🚨 A 54-year-old smoker presents with a strong cough followed by chest pain. 🔴 Anterior STEMI: SCAD? 🔭Wire appears in and out of the true lumen. 📊 IVUS to confirm? Tom Johnson 🩸 No flow post-ballooning jcspratt Next steps? Ziad Ali PCRonline 🫀 Yader Sandoval Natalia Pinilla

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12,762 views • 1 year ago

The Modi government has rebuilt Bharat by presenting the nation with one engineering marvel after another in #11YearsOfInfraRevolution. The newly built state-of-the-art infrastructure projects have strengthened the unity of the nation by bringing the people closer and enabled the voluminous flow of trade and commerce at a speed never seen before.
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The Modi government has rebuilt Bharat by presenting the nation with one engineering marvel after another in #11YearsOfInfraRevolution. The newly built state-of-the-art infrastructure projects have strengthened the unity of the nation by bringing the people closer and enabled the voluminous flow of trade and commerce at a speed never seen before.

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613,620 views • 1 year ago

🟩TIMI TIMI (Thrombolysis in Myocardial Infarction) flow is an angiographic grading system used to describe the degree of epicardial coronary blood flow after reperfusion therapy (thrombolysis or PCI) in acute myocardial infarction. It was developed by the TIMI study group to provide a standardized, reproducible way to assess coronary perfusion on angiography. TIMI flow grades 🟥TIMI 0: No perfusion There is no antegrade flow beyond the point of coronary occlusion. 🟪TIMI 1: Penetration without perfusion Contrast passes beyond the obstruction but fails to opacify the entire distal coronary bed and appears to stagnate. 🟦TIMI 2: Partial perfusion Contrast crosses the obstruction and opacifies the distal bed, but flow and/or clearance is slower than in normal or non-affected coronary segments. 🟩TIMI 3: Complete perfusion Normal antegrade flow with rapid filling and clearance of contrast in the distal coronary bed, comparable to an uninvolved vessel. Key point TIMI flow reflects epicardial coronary artery patency, not microvascular perfusion. Achieving TIMI 3 flow is strongly associated with better clinical outcomes after myocardial infarction. CardiovascularCorner
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🟩TIMI TIMI (Thrombolysis in Myocardial Infarction) flow is an angiographic grading system used to describe the degree of epicardial coronary blood flow after reperfusion therapy (thrombolysis or PCI) in acute myocardial infarction. It was developed by the TIMI study group to provide a standardized, reproducible way to assess coronary perfusion on angiography. TIMI flow grades 🟥TIMI 0: No perfusion There is no antegrade flow beyond the point of coronary occlusion. 🟪TIMI 1: Penetration without perfusion Contrast passes beyond the obstruction but fails to opacify the entire distal coronary bed and appears to stagnate. 🟦TIMI 2: Partial perfusion Contrast crosses the obstruction and opacifies the distal bed, but flow and/or clearance is slower than in normal or non-affected coronary segments. 🟩TIMI 3: Complete perfusion Normal antegrade flow with rapid filling and clearance of contrast in the distal coronary bed, comparable to an uninvolved vessel. Key point TIMI flow reflects epicardial coronary artery patency, not microvascular perfusion. Achieving TIMI 3 flow is strongly associated with better clinical outcomes after myocardial infarction. CardiovascularCorner

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The executive governor of Katsina State, Dr Dikko Umaru Radda, Ph.D. CON. has today led security operatives to some banditry-infected areas in the state for an on-site assessment of the security situation in support of the current efforts by the security operatives to combat the insecurity menace in the state. This was shortly after presiding over the State’s Security Council Meeting today. Ya Allah make these efforts count and grant us peace and tranquility in our state, region and country at large.

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“Mr. President, we love you, but we disagree with your statement that the flooding in Accra is not an engineering problem. There are many engineering challenges in the city, particularly concerning our drainage systems and bridges. The Klagon Bridge is one example, as the engineer chose to use culverts to channel water despite the volume and force of the flow.” — Ghanaian musician Kwaw Kese shares his views on the recurring floods in Greater Accra, arguing that engineering flaws and poor drainage infrastructure are major contributing factors.

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I received the Manufactures association of Nigeria (MAN). Undoubtedly, the significance of the manufacturing sector in any state cannot be overstated. MAN plays a pivotal role in facilitating the transition from a mere seller of produce to an economy with value addition. I commend their resilience and determination in sustaining their presence in the manufacturing sector amid our country's challenges. In Plateau, we remain committed to enhancing the business environment, particularly for manufacturers, to flourish. We anticipate the return of the Coca-Cola production line to Jos, and we are committed to collaborating on any necessary actions. Additionally, we aim to eradicate double taxation, enhancing the cooperative opportunities. Our aspiration is to strengthen our partnership with MAN and accomplish more for our state.

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The Republic of Togo has been thrown into a state of turmoil amidst widespread agitations and protests over constitutional reforms that allow the current president, Faure Gnassingbé to remain in power indefinitely. Youth groups and activists have led the major protests, calling for his immediate resignation in the first ever protests since 2022, after a ban on mass demonstrations was imposed. A son of the former president of Togo, Gnassingbé Eyademéma, the 59-year old was sworn in after the death of his father in 2005 and has since ruled the nation. In May 2025 after a completion of his 20 years rule in February, he was sworn in as the first president of the Council of Ministers, a powerful role that has no official term limits and described by opposition figures as a ‘constitutional coup’.

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313,096 views • 1 year ago

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U.S. forces shot down two Iranian attack drones targeting commercial ships in the Strait of Hormuz just hours after President Trump said he had called off planned strikes on Iran. The incident comes as Washington and Tehran continue negotiating a potential agreement aimed at preventing Iran from obtaining a nuclear weapon. Iranian state media claims a draft deal includes sanctions relief, troop withdrawals, and the release of frozen funds, but major nuclear and economic issues remain unresolved and no final agreement has been signed, Max Gorden reports.

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“This year’s mood is dampened by the abduct!0n of our children in Oyo and borno, we remain hopeful for their safe return. To b@nd!ts, k!dn@pp£rs, and sponsors of terror: surrender or face the full force of the Nigerian state. These windows of surrender will not remain open forever. No mercy will be shown to those who trade in the bluud of Nigerians” - President Tinubu

Oyindamola🙄

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Mayor Frey, unlike Texas, Louisiana and Utah, you and the state of Minnesota refuse to cooperate with ICE. Nearly 470 criminal illegal aliens have been released onto MN streets after your state ignored our detainers. Additionally, over 1,360 criminal illegal aliens remain in state custody, with no indication that our detainers will be honored. Texas, Louisiana and Utah do not ignore our immigration detainers.

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142,791 views • 6 months ago

There's no such thing as a 'slow week' in elephant conservation. Habitats need constant protection, our herd of 80+ dependent elephants requires round-the-clock care, and emergencies are simply part of the work. But even by our standards, last week was exceptional. To read the full week in review, including detailed diary entries for each day, visit:
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There's no such thing as a 'slow week' in elephant conservation. Habitats need constant protection, our herd of 80+ dependent elephants requires round-the-clock care, and emergencies are simply part of the work. But even by our standards, last week was exceptional. To read the full week in review, including detailed diary entries for each day, visit:

Sheldrick Wildlife Trust

12,255 views • 11 months ago

For years now, we have had to deal with congestion and the indiscriminate use of Douglas Road, Owerri, despite its status as a major economic artery of the State. This unfortunate situation has created an enabling environment for the breeding of different classes of criminal elements, thereby undermining public safety, order, and the smooth flow of commercial activities. The deplorable condition of the road further contributed to these challenges, encouraging abuse and illegal movements, particularly by motorists and street traders. Our decision to embark on the reconstruction of this strategic road is in line with our Urban Renewal Project, which is aimed at salvaging the City of Owerri from the looming threat of economic stagnation and reversing the gradual decline in urban development and growth. Beyond restoring critical infrastructure, this intervention seeks to create a more organized, secure, and economically vibrant city, and during my inspection of the project site, I could literally feel the fresh air of relief breathed by residents and users of the road, expressing their appreciation for the transformative impact of our Urban Renewal Projects. The quality and pace of work observed are consistent with the expectations of the Government, and I am pleased that progress remains on track for completion within the contractual timeline. - Hope Uzodimma
1:34

For years now, we have had to deal with congestion and the indiscriminate use of Douglas Road, Owerri, despite its status as a major economic artery of the State. This unfortunate situation has created an enabling environment for the breeding of different classes of criminal elements, thereby undermining public safety, order, and the smooth flow of commercial activities. The deplorable condition of the road further contributed to these challenges, encouraging abuse and illegal movements, particularly by motorists and street traders. Our decision to embark on the reconstruction of this strategic road is in line with our Urban Renewal Project, which is aimed at salvaging the City of Owerri from the looming threat of economic stagnation and reversing the gradual decline in urban development and growth. Beyond restoring critical infrastructure, this intervention seeks to create a more organized, secure, and economically vibrant city, and during my inspection of the project site, I could literally feel the fresh air of relief breathed by residents and users of the road, expressing their appreciation for the transformative impact of our Urban Renewal Projects. The quality and pace of work observed are consistent with the expectations of the Government, and I am pleased that progress remains on track for completion within the contractual timeline. - Hope Uzodimma

Hope Uzodimma

18,787 views • 1 month ago