Types of Coronary Artery Stenotic Lesions | Medicalalgorithms.com

Description

An atherosclerotic plaque in a coronary artery may be classified based on the features seen on coronary angiography. The complexity of a lesions has implications for the degree of risk involved during angioplasty.

Types of lesions:

(A) minimally complex

(B) moderately complex

(C) severely complex

Parameter	Type A	Type B	Type C
length of lesion in mm	discrete ( < 10 mm)	10 – 20 mm	diffuse (> 20 mm)
plaque distribution	concentric	eccentric
angulation of segment	nonangulated (< 45°)	moderate (45 – 90°)	extreme (> 90°)
contour	smooth	irregular
calcification	none or little	moderate or heavy
occlusion	less than total	total occlusion < 3 months old	total occlusion > 3 months old or with bridging collaterals
location	not ostial	ostial
side branch involvement	none	able to protect	unable to protect major side branches
thrombus	absent	some	a lot
tortuosity of proximal segment	slight (readily accessible)	moderate	excessive
other		bifurcation lesions requiring double guide wires	degenerated vein grafts with friable lesions

where:

• The original table does not have an entry for thrombus under Type C.

• The original table does not have an entry for side branch involvement for Type B.

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