Table 10.12 ACC/AHA coronary artery lesion classification (Ref. [70])
From: Cognitive and Decision-Making Skills in Catheter-Based Cardiovascular Interventions
Type A (low risk, expected success >85%) |
Discrete (length <10 mm) |
Concentric |
Readily accessible |
Nonangulated segment (<45°) |
Smooth contour |
Little or no calcification |
Less than totally occlusive |
Not ostial in location |
No major side branch involvement |
Absence of thrombus |
Type B (moderate risk, expected success 60–85%) |
Tubular (length 10–20 mm) |
Eccentric |
Moderate tortuosity of proximal segment |
Moderately angulated segment (>45°, <90°) |
Irregular contour |
Moderate or heavy calcification |
Total occlusions <3 months old |
Ostial in location |
Bifurcation lesions requiring double guide wires |
Some thrombus present |
Type C (high risk, expected success <60%) |
Diffuse (length >20 mm) |
Excessive tortuosity of proximal segment |
Excessive tortuosity of proximal segment |
Extremely angulated segments >90° |
Total occlusions >3 months old and/or bridging collaterals |
Inability to protect major side branches |
Degenerated vein grafts with friable lesions |