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Sanz-Sánchez J, Chiarito M, Gill GS, van der Heijden LC, Piña Y, Cortese B, Alfonso F, von Birgelen C, Diez Gil JL, Waksman R, Garcia-Garcia HM. Small Vessel Coronary Artery Disease: Rationale for Standardized Definition and Critical Appraisal of the Literature. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2022; 1:100403. [PMID: 39131458 PMCID: PMC11307687 DOI: 10.1016/j.jscai.2022.100403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/31/2022] [Accepted: 06/14/2022] [Indexed: 08/13/2024]
Abstract
Small vessel coronary artery disease (CAD) is present in 30% to 67% of patients undergoing percutaneous coronary intervention according to different series, representing an unmet clinical need in light of an increased risk of technical failure, restenosis, and need for repeated revascularization. The definition of small vessel is inconsistent across trials, and no definite cutoff value has yet been determined. The lack of consensus on the definition of small vessel CAD has contributed to the high degree of heterogeneity in the safety and efficacy of the various revascularization options. Therefore, the aim of this article is to provide a critical appraisal of existing reports and to propose a reference vessel diameter of <2.5 mm definition of small vessel CAD to guide future clinical trials and clinical decision-making.
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Affiliation(s)
- Jorge Sanz-Sánchez
- Hospital Universitari i Politecnic La Fe, Valencia, Spain
- Centro de Investigación Biomedica en Red (CIBERCV), Madrid, Spain
| | - Mauro Chiarito
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Clinical and Research Center, Milan, Italy
| | - Gauravpal S. Gill
- Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia
| | | | - Yigal Piña
- Interventional Cardiology, National Heart Institute, Mexico City, Mexico
| | | | | | - Clemens von Birgelen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands
- Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Jose Luis Diez Gil
- Hospital Universitari i Politecnic La Fe, Valencia, Spain
- Centro de Investigación Biomedica en Red (CIBERCV), Madrid, Spain
| | - Ron Waksman
- Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia
| | - Hector M. Garcia-Garcia
- Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia
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