Inflammation is characterized by massive necrosis in the infarcted area. Surgical intervention may be required to remove ruptured or infarcted tissue. On gross examination, coagulative necrosis shows darkened discoloration of the infarcted tissue. It is caused by infarcted muscle tissue, usually in the thigh. Also MiR-1 is downregulated in myocardial infarcted tissue compared to healthy heart tissue. It is used to determine areas of reversible ischemia and infarcted tissue in the heart. Which arteries are problematic will determine which areas of the brain are affected (infarcted).