PCI in the long lesion: Difference between revisions

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'''Key Words and Synonyms:''' diffuse disease, extensive lesion, long lesion


==Overview==
==Overview==
A diffuse lesion is defined as a coronary artery lesion of greater than 20 mm in length. 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.  
A [[diffuse]] [[lesion]] is defined as a [[coronary artery]] [[lesion]] of greater than 20 mm in length. It may also be referred to as [[diffuse]] disease, extensive [[lesion]] or long [[lesion]]. 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 [[lesion]]s that are moderate in nature may therefore cause a significant resistance to flow.
 
==PCI in The Long Lesion==
==Treatment==
===Treatment===
* A single stent that is very long should be placed to minimize stent overlap which is associated with greater risk of [[stent thrombosis]].
* A single [[stent]] that is very long should be placed to minimize [[stent]] overlap which is associated with greater risk of [[stent thrombosis]].
* 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.  
* 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.
* There some data to suggest that [[glycoprotein IIbIIIa inhibition]] is of greater use in longer lesions given the greater extent of [[vessel]] injury.


== Complications==
=== 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.
Long [[lesion]]s are associated with a greater [[plaque]] burden and as such are likewise associated with a greater risk of [[no reflow]]. Longer [[lesion]]s are also associated with an increased risk of side branch [[occlusion]].


==References==
==References==
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{{Reflist|2}}
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Latest revision as of 14:13, 16 January 2013

Percutaneous coronary intervention Microchapters

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

Overview

A diffuse lesion is defined as a coronary artery lesion of greater than 20 mm in length. It may also be referred to as diffuse disease, extensive lesion or long lesion. 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.

PCI in The Long Lesion

Treatment

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

Template:WikiDoc Sources