CV ASC Registry Education-Seq #9146 (Significant Coronary Artery Dissection)

Video Transcription

A dissection is defined as the appearance of contrast materials outside of the expected luminal dimensions of the target vessel and extending longitudinally beyond the length  of the lesion. Because dissections are a frequent occurrence during PCI, the intent of this data element  is to capture the occurrence of a significant dissection as defined by the data definition N1 that is witnessed to occur during the current PCI procedure.  Typically, dissections that are not flow-limiting are considered type A or B and are not captured.  However, significant dissections are captured if they are type C dissections in the presence of ischemia or type D through F dissections, all of which are further described as type  C, which is persisting contrast medium extravasations, type D, spiral-filling defect with delayed  but complete distal flow, type E, persistent filling defect with delayed antegrade flow, or type F, filling defect with impaired flow and total occlusion.

Video Summary

A dissection in the context of PCI occurs when contrast materials are seen outside the expected vessel dimensions, extending beyond the lesion. This data element focuses on capturing significant dissections witnessed during the procedure, excluding non-flow-limiting type A/B dissections. It includes type C dissections with ischemia and type D-F dissections like persistent contrast extravasations (C), spiral-filling defects with delayed flow (D), persistent filling defects with delayed flow (E), or filling defects leading to impaired flow and total occlusion (F). The goal is to document and monitor these types of dissections for further management during PCI procedures.

Keywords

PCI dissections

contrast materials

vessel dimensions

ischemia

extravasations