THE OPEN ARTERY HYPOTHESIS - PAST, PRESENT, AND FUTURE

The survival benefit following a reperfusion strategy, be it pharmacol ogic or mechanical, appears to be due to both full and early reperfusi on. While the TIMI Flow Grade classification scheme has been a useful tool to assess coronary blood now in acute syndromes, it has several l imitations. A newer method of assessing coronary blood flow called the Corrected TIMI Frame Count method has the following advantages: (1) i t is a continuous quantitative variable rather than a categorical qual itative variable; (2) the flow in the non-culprit artery is not assume d to be normal as it is in the assessment of TIMI Grade 3 Flow; (3) th ere 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 th e 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 arter y hypothesis and recent advances in the field.