PCI in the long lesion

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Resistance to coronary blood flow in a coronary vessel is not only due to the severity of a focal stenosis, but also to the length of that stenosis. Long lesions that are moderate in nature may therefore cause a significant resistance to flow.

Treatment

If a bare metal stent is placed, it should be remembered that the risk of restenosis proportional to the length of the bare-metal stent placed in the segment. There some data to suggest that glycoprotein 2b3a inhibition is of greater use in longer lesions given the greater extent of vessel injury.

Complications

Long lesions are associated with a greater plaque burden and as such are likewise associated with a greater risk of no reflow. Longer lesions are also associated with an increased risk of side branch occlusion.

References

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