“…The consideration of anatomic and procedural risk represents the third pillar of risk for patients undergoing PCI and begins with a dedicated heart team that considers a patient-centered approach to anatomic and technical risks and optimal revascularization strategies. 40 , 41 An initial assessment involves recognition of certain high-risk anatomic lesions including left main disease and proximal left anterior descending artery disease, increased number of diseased vessels, chronic total occlusion(s), severe calcification requiring advanced techniques, long lesion length (>60 mm), and in-stent thrombosis, all of which confer increased risk of adverse outcomes. 9 , 15 , 42 , 43 Older patients with coronary artery disease often have high-risk coronary anatomic features that should prompt a systematic approach to minimize procedural risks and optimize outcomes.…”