The Predictive Value of Baseline Target Lesion SYNTAX Score for No-Reflow during Urgent Percutaneous Coronary Intervention in Acute Myocardial Infarction

Figure 1

Calculation of the TL-SS. Coronary tree segments and their vessel segment weighting factor based on the presence of a right of left dominant system (a). Also, a multiplication factor of ×2 segment weighting is used for nonocclusive (50–99% diameter stenosis) lesions and ×5 for total occlusive (100% diameter stenosis) lesions. An example of the calculation of the TL-SS in patients with extensive anterior infarction is shown (b and c). The proximal LAD lesion (white arrow), which was total occlusive, was the culprit lesion and target lesion. The occluded proximal LAD led to the segment weighting 3.5 × 5 points (segment 6). The nonvisible mid and distal LAD segments added 2 additional points. The angiographic feature of the lesion did not fulfill the definition of thrombus of SYNTAX score algorithm. Therefore, the final TL-SS was 3.5 × 5 + 2 = 19.5. The lesions within RCA (c) were not the target lesion and scored as nTL-SS. LAD, left anterior descending coronary artery; nTL-SS, nontarget lesion SYNTAX score; RCA, right coronary artery; and TL-SS, target lesion SYNTAX score.

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