IMR Press / RCM / Volume 23 / Issue 6 / DOI: 10.31083/j.rcm2306209
Open Access Review
Defining Key Features of Complex Coronary Lesions: An Evidence Based Review of Clinical Practice. Part II: Chronic Total Occlusions, Graft Interventions, In-Stent Restenosis, and Antithrombotic Strategies
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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, USA
3 Department of Medicine, Elmhurst Hospital Center, Queens, NY 11373, USA
*Correspondence: george.dangas@mountsinai.org (George Dangas)
Academic Editor: Patrick W.J.C. Serruys
Rev. Cardiovasc. Med. 2022, 23(6), 209; https://doi.org/10.31083/j.rcm2306209
Submitted: 23 February 2022 | Revised: 2 April 2022 | Accepted: 24 April 2022 | Published: 8 June 2022
(This article belongs to the Special Issue Recent Advances in Percutaneous Coronary Intervention)
Copyright: © 2022 The Author(s). Published by IMR Press.
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 two of this review focuses on the indications to treat chronic total occlusions, interventions of failed grafts, tools used to treat in-stent restenosis, as well as antithrombotic strategies.

Keywords
complex percutaneous intervention
chronic total occlusion
in-stent restenosis
saphenous vein graft
dual antiplatelet
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