Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
PCI: classification of the lesion
Introduction
Overview
Overview
According to the Abrupt Vessel Closure – AHA Task Force Definition, as modified by Ellis et al., coronary lesion complexity is typed as A, B1, B2, and C.[1][2][3]
Classification of the Lesion
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 B1
One of the following characteristics: 10-20mm, eccentric, moderate tortuosity of 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
References
- ↑ Ryan TJ, Faxon DP, Gunnar RM, Kennedy JW, King SB III, Loop FD,Peterson KL, Reeves TJ, Williams DO, Winters WL Jr, et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation 1988;78:486–502.
- ↑ Ellis, SG.; Roubin, GS.; King, SB.; Douglas, JS.; Weintraub, WS.; Thomas, RG.; Cox, WR. (1988). “Angiographic and clinical predictors of acute closure after native vessel coronary angioplasty”. Circulation. 77 (2): 372–9. PMID 2962787. Unknown parameter
|month=ignored (help) - ↑ Ellis SG, Vandormael MG, Cowley MJ, DiSciascio G, Deligonul U, Topol EJ, Bulle TM. Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Multivessel Angioplasty Prognosis Study Group. Circulation 1990;82:1193–1202.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]