PCI: classification of the lesion: Difference between revisions

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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==