Morphological characteristics of lesions have been widely studied in coronary artery disease and carotid artery disease, but the enigma still remains in evaluating precisely which morphological characteristics and findings will predict better outcome of endovascular treatment in patients with advanced arterial occlusive disease. In coronary arteries, echolucent zones identified using intravascular ultrasound were found to increase the risk of clinical instability.1 Paraskevaidis et al.2 studied the potential correlation between angiographic lesion morphology and the early and 1-year clinical outcomes in patients with unstable angina. They classified the morphology of the culprit lesion as simple or complex according to Ambrose's modified criteria.3'4 Simple lesions included concentric and eccentric lesions of type IA and type IB. Complex lesions included eccentric lesions of type IIA and MB, multiple irregularities, tandem lesions, presence of thrombus, total occlusions, and TIMI flow grade <3 occlusions.5 They concluded that angiographic classification of the culprit lesion as simple or complex was not correlated with the clinical outcome of patients with unstable angina, while the presence of thrombus, angulation of the lesion between 45° and 90°, and irregular contour of the culprit lesion were correlated.
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