TLR
Also written as: TLR — Target Lesion Revascularization
Target lesion revascularization representing repeat intervention at the previously treated coronary segment driven by angiographic restenosis or clinical symptoms.
Full Definition
Target lesion revascularization (TLR) is defined as repeat percutaneous or surgical intervention at the target lesion site, including the stent and 5mm proximal and distal segments. TLR typically occurs due to binary angiographic restenosis (>50% diameter stenosis) associated with clinical symptoms, positive functional testing, or fractional flow reserve ≤0.80. This endpoint serves as a clinically relevant measure of treatment failure in interventional cardiology trials, reflecting both device efficacy and patient symptoms. TLR can be further classified as clinically driven (symptoms or ischemia) versus not clinically driven (angiographic findings alone). Contemporary definitions emphasize clinical indication for repeat intervention rather than purely angiographic criteria to improve clinical relevance.
Usage
Usage note: Distinguish from TVR (target vessel revascularization) which includes the entire target vessel; specify clinically driven vs. not clinically driven when relevant.
In Context
- "Clinically driven TLR at 12 months was significantly reduced in the drug-eluting stent group (4.2% vs 11.8%, p=0.003)." — Clinical outcomes analysis
- "The composite primary endpoint included cardiovascular death, target vessel myocardial infarction, and TLR." — Primary endpoint definition