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95 7 2 ! ACC/AHA/SCAI !"#$%&'() Percutaneous Coronary Intervention 2005 !"# 2005 Guideline Update PART I/III * !"=! !"#$%"#$&' !"#$%&'()*+,-./0 !"#$%&'()*+,-./ !"#$%&'()*+,-./0 !"#PCIs!"#!$% !"#$%&'()*+,-./0 !"#$%&'()*+,-./0 !"#$%&'(percutaneous trans- luminal coronary angioplasty-PTCA PCI !"#$%&'()*+,-./ !"#$%&'()*+,)-./ !"#$%&'()*+,-./' !"#$%&'( PCI !" !"#$%&'()*+,-./0 !"#$%&'()*+,-./0 !"#$%&'()*+,-./0 glycoproteinGPIIb/IIIa receptor antagonists ! bivalirudin thienopyridines ! !" DES!"#$%&' 2001 !"#$%&'() PCI !"#$%&'()*+ PCI !"#$%&'()*+, !"#$%&'()*+,-./0 ! ACC/AHA/SCAI !"#$ 2001 PCI !"# * !"#$%&'()*#+,-. !"#$% class IIa !"#$ !"#$ Class I: ! / !"#$%& !"# ! ! Class II: !"#$%&' / ! ! / !" Class IIa: / !"#$%& /

ACC/AHA/SCAI · 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

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Page 1: ACC/AHA/SCAI · 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

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Page 2: ACC/AHA/SCAI · 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

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Page 3: ACC/AHA/SCAI · 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

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Page 4: ACC/AHA/SCAI · 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

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Page 5: ACC/AHA/SCAI · 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

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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).

Page 6: ACC/AHA/SCAI · 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

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Page 7: ACC/AHA/SCAI · 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

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Page 8: ACC/AHA/SCAI · 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

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Page 9: ACC/AHA/SCAI · 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

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