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Percutaneous coronary intervention for small vessel coronary artery disease
Authors:Giuseppe Biondi-Zoccai  Claudio Moretti  Antonio Abbate  Imad Sheiban
Affiliation:1. Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK;2. Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK;3. Queen Elizabeth Hospital NHS Trust, Birmingham, UK;4. Belfast NHS Trust, Belfast, UK;5. Department of Mathematics, Sussex University, UK;6. King''s Health Partners, Rayne Institute, St Thomas'' Campus, London, UK;7. The James Cook University Hospital, Middlesbrough, UK;1. Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands;2. Department of Cardiology, Rijnstate Hospital, Arnhem, the Netherlands;3. Department of Cardiology, Treant Zorggroep, Location Scheper, Emmen, the Netherlands;4. Department of Cardiology, Ziekenhuisgroep Twente, Almelo and Hengelo, the Netherlands;5. Health Technology and Services Research, MIRA—Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands
Abstract:Symptomatic coronary artery disease may be commonly due to significant atherosclerotic disease involving coronary vessels of relatively small caliber (i.e., with reference vessel diameter <2.75 mm). Whenever medical therapy fails and in other selected cases, revascularization by means of percutaneous coronary intervention (PCI) or bypass surgery is indicated even for small vessel coronary disease. However, despite the numerous developments and improvements in devices and techniques, PCI of small coronary vessels is still fraught with a significant risk of midterm restenosis after both balloon-only PCI and bare-metal stent implantation. Drug-eluting stents, especially those associated with very low angiographic late lumen loss (<0.20 mm), appear to significantly improve angiographic and clinical outcomes after PCI of small coronary vessels. The present article provides a concise and updated review on percutaneous coronary revascularization in patients with symptomatic small vessel coronary artery disease.
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