RT Book, Section
A1 Hermiller, James B.
A1 Russell, Evan T.
A2 Samady, Habib
A2 Fearon, William F.
A2 Yeung, Alan C.
A2 King III, Spencer B.
SR Print(0)
ID 1146599789
T1 Special Considerations: Small Vessel and Diffuse Disease
T2 Interventional Cardiology, 2e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071820363
LK accesscardiology.mhmedical.com/content.aspx?aid=1146599789
RD 2023/03/25
AB Small  vessel  disease  and  diffuse  coronary  artery  disease  represent  particularly  challenging  subsets  for  treatment  with  transcatheter  coronary  interventional  therapies.  This  pathology  is  associated  with  higher  risk  comorbidities,  such  as  diabetes,  and  is  more  frequently  associated  with  female  gender  and  diffuse  coronary  involvement.1  Small  and  diffusely  diseased  vessels  are  frequently  noncompliant,  calcified,  tortuous,  and  distal  in  location,  making  these  targets  more  technically  challenging  for  intervention.  Consequently,  a  higher  incidence  of  acute  complications,  including  significant  vessel  dissection,  acute  vessel  closure,  myocardial  infarction,  and  emergent  coronary  bypass  grafting,  has  historically  complicated  intervention  in  small  and  diffusely  diseased  vessels.2,3  Along  with  poorer  acute  outcomes,  these  subsets  are  plagued  by  high  restenosis  and  thrombosis  rates,  often  necessitating  repeat  intervention  or  bypass  surgery.4,5  Despite  the  challenges  and  complexities  inherent  to  small  vessel  intervention,  the  problem  is  common.  Between  30%  and  67%  of  all  percutaneous  coronary  interventions  involve  small  vessels,  depending  on  the  definition  of  a  small  vessel.6-9