ostial lesion
A stenotic lesion located at the origin or mouth of a coronary vessel, presenting unique technical challenges for intervention.
Full Definition
An ostial lesion refers to significant coronary stenosis located within 3mm of a vessel's origin, whether at the coronary artery ostium from the aorta or at branch vessel origins. These lesions present unique challenges including difficulty achieving adequate guide catheter support, tendency for elastic recoil after balloon dilation, and higher rates of restenosis. Ostial lesions often require aggressive lesion preparation with cutting balloons or atherectomy, precise stent positioning to avoid geographical miss or protrusion into the aorta, and post-dilatation with non-compliant balloons. The rigid fibrotic nature of ostial tissue frequently necessitates higher deployment pressures and may benefit from intravascular imaging guidance to ensure optimal stent expansion and apposition.
Usage
Usage note: Specify whether lesion is aorto-ostial or branch ostial in documentation.
In Context
- "The ostial RCA lesion required cutting balloon preparation followed by high-pressure stent deployment." — Complex lesion intervention report
- "IVUS confirmed adequate ostial lesion coverage without stent protrusion into the aortic cusp." — Intravascular imaging assessment