PCI: classification of the lesion: Difference between revisions

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PCI in Specific Lesion Types
Classification of the Lesion The Calcified Lesion The Ostial Lesion The Angulated or Tortuous Lesion The Bifurcation Lesion The Long Lesion The Bridge Lesion Vasospasm The Chronic Total Occlusion The Left Internal Mammary Artery Multivessel Disease Distal Anastomotic Lesions Left Main Intervention The Thrombotic Lesion
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Revision as of 19:42, 16 January 2013

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 graded as A, B1, B2, and C.

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 B

One 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 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

Template:WikiDoc Sources

@@ Line 4: / Line 4: @@
 ==Overview==
-According to the Abrupt Vessel Closure - AHA Task Force Definition, as modified by Ellis et al., coronary [[lesion]] complexity is graded as A, B1, B2, and C.
+According to the Abrupt Vessel Closure - AHA Task Force Definition, as modified by Ellis et al., [[coronary artery|coronary]] [[lesion]] complexity is graded as A, B1, B2, and C.
+==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 A==
+===Type B===
-<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 B==
 One of the following characteristics:
--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 guide wires.
+-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 B2==
+===Type B2===
 Two or more of the following characteristics:
--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 guide wires.
+-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==
+===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==