PCI in the angulated or tortuous lesion

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Overview

Severe tortuosity and moderate-to-severe calcification have long been identified as significant predictors of procedure failure, as well as worse clinical outcomes.

Angulated Lesions

  • In the settings of coronary stenting, angulated lesions represent a challenge due to the inability of delivering the stent to the stenosis and straightening of the arterial silhouette after stent implantation that may predispose to the presence of stent fracture.
  • Vessel curvature at the site of maximum stenosis should be measured in the most unforeshortened projection using a length of curvature that approximates the balloon length used for coronary dilation.

Goals of Treatment

In the treatment of angulated and tortuous lesions, the main goals include successfully delivering the equipment, avoiding complications, and maximizing procedural success.

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