Coronary angiography ACC-AHA characteristics of type A, B, and C coronary lesions

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

ACC-AHA Characteristics of Type A, B, and C Coronary Lesions

Type A Lesions (High Success [> 85%]; Low Risk)

  • Discrete (< 10 mm)
  • Little or no calcium
  • Concentric
  • Less than totally occlusive
  • Readily accessible
  • Not ostial in location
  • Nonangulated segment (< 45 degrees)
  • No major side branch involvement
  • Smooth contour
  • Absence of thrombus

Type B Lesions (Moderate Success [60%–85%]; Moderate Risk)

  • Tubular (10–20 mm length)
  • Moderate to heavy calcification
  • Eccentric
  • Total occlusions < 3 months old
  • Moderate tortuosity of proximal segment
  • Ostial in location
  • Moderately angulated (45-90 degrees)
  • Bifurcation lesion requiring double guidewire
  • Irregular contour
  • Some thrombus present

Type C Lesions (Low Success [< 60%]; High Risk)

  • Diffuse (> 20 mm length)
  • Total occlusion > 3 months old
  • Excessive tortuosity of proximal segment
  • Inability to protect major side branches
  • Extremely angulated segment (> 90 degrees)
  • Degenerated vein grafts with friable lesions