What is an Intermediate coronary lesion & What shall we do with it ?

This question might squeeze the collective coronary knowledge of any cardiologist. (At least, it does for me !) What is an intermediate coronary lesion? (ICL)  Traditionally it is an “angio-ocular reflex” measurement of coronary arterial diameter stenosis that lies between 40 to 70% (Mind you, 70 diameter stenosis is 90% area. So,we must be clear what we really mean in any  revascularisation debate). Above one is the simplest expression of ICL. (* While 70% cutoff is fairly constant, the lower limit 40% is still not a settled issue. It can even be 30 %. I think we haven’t yet named the lesions 1 to 39%. It is the spectrum that contains  Coronary erosions, ulcers, luminal irregularity, or the evasive term minimal CAD  ) Many sub-classes exist in ICL. Should ICL definition be different in proximal LAD? (A 40% PDA or OM2 lesion is not the same as 50% LAD right.Maybe we need to artery specific redefinition, left main we did it already) It can be de nova chronic (most common ) Acute  /subacute, acute recanalization (Each has a different management strategy) ICL good TIMI 3 flow. Mostly safe and ignored. Should we bother to know the content of ICL? It could be a minor plaque or just thickened and narrowed arterial wall or even layered thrombus. Is it isolated ICL?  When ICL occurs in isolation it gets more attention is natural to ignore if ICLs are noted along with other critical lesions nearby. The risk of ignoring or ri...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized diameter vs area stenosis fame s fame study ffr ifr qfr intermediate coronary lesion minimal cad coronary erosion what is intermediate coronary lesion ? Source Type: blogs