PCI in the long lesion: Difference between revisions
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==Overview== | ==Overview== | ||
A diffuse lesion is defined as a coronary artery lesion of greater than 20 mm in length. | 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. | ||
==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 2b3a 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 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. |
Revision as of 19:47, 11 January 2013
Percutaneous coronary intervention Microchapters |
PCI Complications |
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PCI in Specific Patients |
PCI in Specific Lesion Types |
PCI in the long lesion On the Web |
American Roentgen Ray Society Images of PCI in the long lesion |
Directions to Hospitals Treating Percutaneous coronary intervention |
Risk calculators and risk factors for PCI in the long lesion |
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.
Treatment
- 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.
- 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.