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Intermediate Technical IVT

culprit vessel

The coronary artery responsible for an acute coronary syndrome, identified by clinical and angiographic criteria.

Full Definition

The culprit vessel is the specific coronary artery that has caused an acute myocardial infarction or unstable angina, typically identified by the combination of electrocardiographic changes, wall motion abnormalities, and angiographic findings such as thrombus, plaque rupture, or acute occlusion. In ST-elevation myocardial infarction, the culprit vessel usually correlates with the ECG territory of ST elevation. Identification of the culprit vessel is crucial for directing immediate revascularization efforts and determining the primary intervention target during acute coronary syndrome management.

Usage

Usage note: Distinguish from non-culprit vessels that may have chronic disease but are not acutely causing symptoms.

In Context

  • "Coronary angiography identified the proximal LAD as the culprit vessel with acute thrombotic occlusion." — Cardiac catheterization report
  • "Despite multivessel disease, only the culprit vessel was treated during the primary PCI procedure." — STEMI intervention note

Also known as

infarct-related artery IRA

Don't confuse with

target vessel bystander vessel

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