geographic miss
Incomplete stent coverage of a diseased coronary segment, leaving untreated atherosclerotic plaque at the lesion margins.
Full Definition
Geographic miss refers to inadequate stent coverage that leaves significant atherosclerotic disease untreated at either the proximal or distal margins of the target lesion. This technical failure occurs when the stent is positioned too distally or proximally, or when the selected stent is too short to cover the entire diseased segment. Geographic miss is associated with increased rates of target lesion revascularization, as the uncovered atherosclerotic plaque remains prone to progression and clinical events. The phenomenon is best identified using intravascular imaging, which can detect residual plaque burden >40% at stent edges that appears angiographically normal. Prevention requires careful lesion assessment, appropriate stent sizing, and precise positioning with adequate healthy vessel landing zones.
Usage
Usage note: Document specific location and extent when geographic miss is identified.
In Context
- "IVUS revealed geographic miss with 55% plaque burden at the proximal stent edge requiring additional stent placement." — Intravascular imaging assessment
- "The target lesion revascularization was attributed to geographic miss identified on follow-up angiography." — Repeat intervention documentation