PCI: classification of the lesion: Difference between revisions
No edit summary |
|||
| (10 intermediate revisions by 4 users not shown) | |||
| Line 1: | Line 1: | ||
{{ | __NOTOC__ | ||
{{ | {{Main|Coronary angiography ACC-AHA characteristics of type A, B, and C coronary lesions}} | ||
{{PCI}} | |||
{{CMG}} | {{CMG}} | ||
{{ | ==Overview== | ||
According to the Abrupt Vessel Closure - AHA Task Force Definition, as modified by Ellis et al., [[coronary artery|coronary]] [[lesion]] complexity is typed as A, B1, B2, and C.<ref>Ryan TJ, Faxon DP, Gunnar RM, Kennedy JW, King SB III, Loop FD,Peterson KL, Reeves TJ, Williams DO, Winters WL Jr, et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation 1988;78:486–502.</ref><ref name="Ellis-1988">{{Cite journal | last1 = Ellis | first1 = SG. | last2 = Roubin | first2 = GS. | last3 = King | first3 = SB. | last4 = Douglas | first4 = JS. | last5 = Weintraub | first5 = WS. | last6 = Thomas | first6 = RG. | last7 = Cox | first7 = WR. | title = Angiographic and clinical predictors of acute closure after native vessel coronary angioplasty. | journal = Circulation | volume = 77 | issue = 2 | pages = 372-9 | month = Feb | year = 1988 | doi = | PMID = 2962787 }}</ref><ref>Ellis SG, Vandormael MG, Cowley MJ, DiSciascio G, Deligonul U, Topol EJ, Bulle TM. Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Multivessel Angioplasty Prognosis Study Group. Circulation 1990;82:1193–1202.</ref> | |||
==Classification of the Lesion== | |||
===Type A=== | |||
<10mm, discrete, concentric readily accessible, <45 degree angle smooth contour, little or no [[calcification]], less than totally occluded, not [[ostium|ostial]], no major side branch involvement, absence of [[thrombus]]. | |||
===Type B1=== | |||
One of the following characteristics: | One of the following characteristics: | ||
10-20mm, eccentric, moderate tortuosity | 10-20mm, eccentric, moderate [[tortuosity]] of [[proximal]] segment, irregular contour, presence of any [[thrombus]] grade, moderate or heavy [[calcification]], total [[occlusion]] <3 months old, [[ostium|ostial]] [[lesion]] or bifurcation [[lesion]] requiring two [[guidewire]]s. | ||
===Type B2=== | |||
Two or more of the following characteristics: | Two or more of the following characteristics: | ||
10-20mm, eccentric, moderate [[tortuosity]] or proximal segment, irregular contour, presence of any [[thrombus]] grade, moderate or heavy [[calcification]], total [[occlusion]] <3 months old, ostial [[lesion]] or bifurcation [[lesion]] requiring two | 10-20mm, eccentric, moderate [[tortuosity]] or [[proximal]] segment, irregular contour, presence of any [[thrombus]] grade, moderate or heavy [[calcification]], total [[occlusion]] <3 months old, [[ostium|ostial]] [[lesion]] or bifurcation [[lesion]] requiring two [[guidewire]]s. | ||
===Type C=== | |||
>20 mm diffuse, excessive [[tortuosity]] of proximal segment, total [[occlusion]] >3 months old and/or bridging [[collaterals]] inability to protect major side branches, degenerated [[Saphenous vein graft|vein graft]] with friable [[lesions]]. | >20 mm [[diffuse]], excessive [[tortuosity]] of [[proximal]] segment, total [[occlusion]] >3 months old and/or bridging [[collaterals]] inability to protect major side branches, degenerated [[Saphenous vein graft|vein graft]] with friable [[lesions]]. | ||
==References== | |||
{{Reflist|2}} | |||
[[Category:Angiopedia]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
{{ | [[Category:Up-To-Date]] | ||
[[Category:Up-To-Date cardiology]] | |||
{{Coronary Angiography}} | |||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
Latest revision as of 18:12, 22 October 2013
|
Percutaneous coronary intervention Microchapters |
|
PCI Complications |
|---|
|
PCI in Specific Patients |
|
PCI in Specific Lesion Types |
|
PCI: classification of the lesion On the Web |
|
American Roentgen Ray Society Images of PCI: classification of the lesion |
|
Directions to Hospitals Treating Percutaneous coronary intervention |
|
Risk calculators and risk factors for PCI: classification of the lesion |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
According to the Abrupt Vessel Closure - AHA Task Force Definition, as modified by Ellis et al., coronary lesion complexity is typed as A, B1, B2, and C.[1][2][3]
Classification of the Lesion
Type A
<10mm, discrete, concentric readily accessible, <45 degree angle smooth contour, little or no calcification, less than totally occluded, not ostial, no major side branch involvement, absence of thrombus.
Type B1
One of the following characteristics: 10-20mm, eccentric, moderate tortuosity of proximal segment, irregular contour, presence of any thrombus grade, moderate or heavy calcification, total occlusion <3 months old, ostial lesion or bifurcation lesion requiring two guidewires.
Type B2
Two or more of the following characteristics: 10-20mm, eccentric, moderate tortuosity or proximal segment, irregular contour, presence of any thrombus grade, moderate or heavy calcification, total occlusion <3 months old, ostial lesion or bifurcation lesion requiring two guidewires.
Type C
>20 mm diffuse, excessive tortuosity of proximal segment, total occlusion >3 months old and/or bridging collaterals inability to protect major side branches, degenerated vein graft with friable lesions.
References
- ↑ Ryan TJ, Faxon DP, Gunnar RM, Kennedy JW, King SB III, Loop FD,Peterson KL, Reeves TJ, Williams DO, Winters WL Jr, et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation 1988;78:486–502.
- ↑ Ellis, SG.; Roubin, GS.; King, SB.; Douglas, JS.; Weintraub, WS.; Thomas, RG.; Cox, WR. (1988). "Angiographic and clinical predictors of acute closure after native vessel coronary angioplasty". Circulation. 77 (2): 372–9. PMID 2962787. Unknown parameter
|month=ignored (help) - ↑ Ellis SG, Vandormael MG, Cowley MJ, DiSciascio G, Deligonul U, Topol EJ, Bulle TM. Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Multivessel Angioplasty Prognosis Study Group. Circulation 1990;82:1193–1202.