CC-BY-NC-ND 4.0 · Ind J Car Dis Wom 2017; 02(04): 111-118
DOI: 10.1055/s-0038-1624066
Interventional Rounds
Women in Cardiology and Related Sciences

Small Vessel Angioplasty

Lalita Nemani
Department of Cardiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India
› Author Affiliations
Further Information

Publication History

Publication Date:
04 May 2018 (online)

Introduction

The term “small vessel” denotes a coronary artery with reference vessel diameter (RVD) < 2.8 to 3.0 mm.[1] Lesions involving small vessels account for 40 to 50% of all coronary stenosis.[2] Revascularization of these vessels is impeded by high technical failure in coronary artery bypass grafting (CABG) and increased risk of adverse events and restenosis with percutaneous coronary intervention (PCI). Intervention in small coronary vessels constitutes 30 to 50% of all intervention procedures performed worldwide every year.[3] [4] [5]

The arbitrary upper limit of lumen diameter is between 2.5 and 2.75 mm. However, with the availability of 2.25- and 2-mm-diameter stents, the term “very small vessel disease” has been suggested to lesions that are amenable to PCI with these devices. PCI in these vessels is considered controversial because (1) these vessels perfuse a small territory and may not be worth stenting, (2) they have a higher risk of dissection, perforation, and restenosis, and (3) they are technically more challenging in terms of lesion crossability. The decision to stent these vessels should be interpreted with the clinical scenario of the patient in mind.