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Table 6. Lesion Classification System
Descriptions of a High-Risk Lesion (Type C Lesion)Diffuse (length greater than 2 cm)Excessive tortuosity of proximal segmentExtremely angulated segments, greater than 90ºTotal occlusions more than 3 months old and/or bridging collaterals*Inability to protect major side branchesDegenerated vein grafts with friable lesions*
*The high risk with these criteria is for technical failure and increased restenosis, not for acute complications.
Table 7. SCAI Lesion Classification System: Characteristics of Class I-IV Lesions
Type I lesions (highest success expected, lowest risk)(1) Does not meet criteria for C lesion(2) Patent
Type II lesions(1) Meets any of these criteria for ACC/AHA C lesion
Diffuse (greater than 2 cm length)Excessive tortuosity of proximal segmentExtremely angulated segments, greater than 90ºInability to protect major side branchesDegenerated vein grafts with friable lesions
(2) PatentType III lesions
(1) Does not meet criteria for C lesion(2) Occluded
Type IV lesions(1) Meets any of the criteria for ACC/AHA C lesion
Diffuse (greater than 2 cm length)Excessive tortuosity of proximal segmentExtremely angulated segmens, greater than 90ºInability to protect major side branchesDegenerated vein grafts with friable lesionsOccluded for more than 3 months
(2) Occluded
Reprinted from Krone et al. Evaluation of the American College of Cardiology/American Heart Association and the Society forCoronary Angiography and Interventions lesion classification system in the current “stent era” of coronary interventions (from theACC-National Cardiovascular Data Registry®). Am J Cardiol 2003;92:394 (Appendix B) (132).
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