dec 16, 2021 by Philips
Reading time: 1-2 minutes

Diffuse Disease

Approximately 20% of the coronary lesions treated today are long and diffuse.1,2

CTO masthead

Clinical challenges

  • Diffuse or long lesions are associated with decreased proceduralsuccess and are associated with higher rates of restenosis.
        – Stent length is an independent predictor of in-stent restenosis and thrombosis.
        – Stenting long segments with multiple and or overlapping stents may lead to injury to the vessel wall integrity.


  • Angiography alone may not be able to identify the critical lesion.
         – Diffuse CAD may be underestimated by evaluation with coronary angiography.
         – Determining reference vessel sizing can be challenging when the vessel is diffusely diseased.

IVUS-guided vs. angiography-guided outcomes3

ISR more Luminal

Advanced tools for optimal PCI outcomes

iFR software image

  • Maps iFR physiological drops to identify critical stenoses. 
  • Creates length measurements without a pullback device, plan your procedure and see the physiologic impact of a virtual stent.

IVUS software image

  • Guides stenting of the most severely diseased areas, eliminating the need for implantation of long stents. 
  • Study data (IVUS-XPL) reported IVUS was associated with a 50% reduction in MACE at 5 year with Xience Prime stents ≥28 mm.4

Angio Sculpt Evo RX PTCA scoring balloon catheter

  • Provides the power necessary to maximize lume diameter.
  • Delivers 15-25x’s the focal force of a traditional balloon.

ELCA product

  • Creates a channel to facilitate definitive therapy delivery. 
  • Prepares long segment to optimize stent and wall apposition (indicated for lesions >20mm).

Share this article

Sign up to receive news and updates from Philips



1. Xu B., Gao R. L., Zhang R. Y., et al. Efficacy and safety of FIREHAWK abluminal groove filled biodegradable polymer sirolimus-eluting stents for the treatment of long coronary lesions: nine-month angiographic and one-year clinical results from TARGET I trial long cohort. Chinese Medical Journal. 2013;126(6):1026–1032.

2. Ahn J. M., Park D. W., Kim Y. H., et al. Comparison of resolute zotarolimus-eluting stents and sirolimus-eluting stents in patients with de novo long coronary artery lesions a randomized LONG-DES IV trial. Circulation: Cardiovascular Interventions. 2012;5(5):633–640.

3. Costa JR, Mintz GS, Carlier SG, et al. Nonrandomized comparison of coronary stenting under intravascular ultrasound guidance of direct stenting without predilation versus conventional predilation with a semi-compliant balloon versus predilation with a new scoring balloon. Am J Cardiol. 2007;100:812-817.

4. Hong S-J, et al. “Effect of Intravascular Ultrasound-guided Drug-Eluting Stent Implantation: Five-Year Follow-Up of the IVUS-XPL Randomized Trial, JACC: Cardiovascular Interventions (2020), doi:
5. Weisz, G., Metzger, D. C., Liberman, H. A., O'Shaughnessy, C. D., Douglas, J. S., Jr, Turco, M. A., Mehran, R., Gershony, G., Leon, M. B., & Moses, J. W. (2013). A provisional strategy for treating true bifurcation lesions employing a scoring balloon for the side branch: final results of the AGILITY trial. Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions, 82(3), 352–359.

We are always interested in engaging with you.

Let us know how we can help.

Select your area of interest
Contact details

You are about to visit a Philips global content page


You are about to visit a Philips global content page


Vår webbplats visas bäst i senaste versionen av Microsoft Edge, Google Chrome eller Firefox.