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Advanced Technical IVT

slow flow

Angiographic phenomenon of delayed contrast clearance from coronary vessels despite absence of epicardial obstruction.

Full Definition

Slow flow is an angiographic finding characterized by delayed opacification and clearance of contrast material from coronary vessels in the absence of significant epicardial stenosis or mechanical obstruction. This phenomenon typically manifests as TIMI 2 flow or prolonged TIMI frame count during coronary angiography. Slow flow can occur spontaneously or develop during percutaneous coronary intervention, often indicating microvascular dysfunction, distal embolization, or coronary spasm. Contributing factors include platelet aggregation, inflammation, endothelial dysfunction, or mechanical trauma from intervention. Treatment approaches may include intracoronary vasodilators (verapamil, nicardipine), antithrombotic agents, or mechanical thrombectomy depending on the suspected underlying mechanism. Slow flow is associated with larger infarct size and worse clinical outcomes in acute coronary syndromes.

Usage

Usage note: Distinguish from no-reflow phenomenon in clinical documentation.

In Context

  • "Intracoronary verapamil was administered to address slow flow in the LAD following stent deployment." — Periprocedural complication management
  • "The patient developed slow flow during primary PCI despite successful stent placement and optimal angiographic result." — STEMI intervention report

Also known as

TIMI 2 flow delayed flow

Contrasted with

TIMI 3 flow normal flow

Don't confuse with

no-reflow TIMI 1 flow

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