PCI in the angulated or tortuous lesion
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Overview
Severe tortuosity and moderate-to-severe calcification have long been identified as significant predictors of procedure failure, as well as worse clinical outcomes.
Angulated Lesions
- Balloon angioplasty of highly angulated lesions is associated with an increased for risk coronary dissection.
- In the settings of coronary stenting, angulated lesions represent a challenge due to the inability of delivering the stent to the stenosis and straightening of the arterial silhouette after stent implantation that may predispose to the presence of stent fracture.
- Vessel curvature at the site of maximum stenosis should be measured in the most unforeshortened projection using a length of curvature that approximates the balloon length used for coronary dilation.