Defining Key Features of Complex Coronary Lesions: An Evidence Based Review of Clinical Practice. Part I: Bifurcations, Left Main Disease, and Calcifications

Daniel Feldman^1,2, Frans Beerkens^1,2, Johny Nicolas², Mohan Satish^1,2, Davis Jones^1,2, James W. Johnson^1,2, George Dangas^1,*

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¹ The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA

² Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA

^*Correspondence: george.dangas@mountsinai.org (George Dangas)
Academic Editor: Patrick W.J.C. Serruys

Rev. Cardiovasc. Med. 2022, 23(6), 197; https://doi.org/10.31083/j.rcm2306197

Submitted: 23 February 2022 | Revised: 1 April 2022 | Accepted: 24 April 2022 | Published: 27 May 2022

(This article belongs to the Special Issue Recent Advances in Percutaneous Coronary Intervention)

This is an open access article under the CC BY 4.0 license.

Abstract

Clinicians have long recognized that certain features of coronary artery lesions increase the complexity of intervention. Complex lesions are associated with worse cardiovascular outcomes and a higher risk of subsequent ischemic events. These lesions are categorized by their angiographic features. These features include bifurcation lesions, left main coronary artery disease, calcified lesions, in-stent restenosis, chronic total occlusions and graft interventions. This two-part review aims to highlight the current evidence in the percutaneous management of these lesions. Part one of this review focuses on the best techniques to treat bifurcation lesions, indications for intervention of left main coronary artery disease and additional tools used to treat calcified lesions.

Keywords

complex percutaneous intervention

left main coronary artery disease

bifurcation lesions

calcified lesions

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Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174