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Angiographic Predictors for Repeated Revascularization in Patients with Intermediate Coronary Lesions
Yong-Kyun Kim1, Soon-Ho Kwon1, Young-Hoon Seo1
1Division of Cardiology, Department of Internal Medicine, Konyang University Hospital, Daejeon 35365, Republic of Korea.
Biomedicines
|January 8, 2025
Summary
Angiographic haziness and diameter stenosis over 60% predict the need for target lesion revascularization in intermediate coronary lesions. These findings aid in guiding treatment decisions for complex intermediate lesions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Imaging
Background:
- Intermediate lesions (ILs) pose challenges in therapeutic decision-making.
- Accurate prediction of revascularization needs is crucial for optimal patient management.
Purpose of the Study:
- To identify practical coronary angiographic predictors for target lesion revascularization (TLR) in patients with ILs.
- To evaluate the association between specific angiographic features and the need for revascularization.
Main Methods:
- Retrospective single-center study of patients with ILs undergoing repeated angiograms.
- Comparison of angiographic characteristics between patients who did and did not undergo TLR.
- Analysis of lesion features including branches, irregularity, tortuosity, ulcer/erosion, haziness, and calcification.
Main Results:
- Higher percentage of diameter stenosis (% DS) and presence of haziness were observed in the TLR group.
- Angiographic haziness (HR=2.126) and % DS ≥ 60% (HR=1.025) were independent predictors of TLR.
- Lesion length did not show significant differences between groups.
Conclusions:
- Angiographic haziness and % DS > 60% are independent predictors for TLR in patients with ILs.
- These findings represent the first angiographic identification of vulnerable plaques in ILs.
- Intravascular imaging or physiologic studies are recommended for ILs with these features before treatment decisions.
