Classification of coronary artery bifurcation lesions and treatments:: Time for a consensus!

被引：233

作者：

Louvard, Yves ^{[1
]}

Thomas, Martyn ^{[2
]}

Dzavik, Vladimir ^{[3
]}

Hildick-Smith, David ^{[4
]}

Galassi, Alfredo R. ^{[5
]}

Pan, Manuel ^{[6
]}

Burzotta, Francisco ^{[7
]}

Zelizko, Michael ^{[8
]}

Dudek, Darius ^{[9
]}

Ludman, Peter ^{[10
]}

Sheiban, Imad ^{[11
]}

Lassen, Jens F. ^{[12
]}

Darremont, Olivier ^{[13
]}

Kastrati, Adnan ^{[14
]}

Ludwig, Josef ^{[15
]}

Iakovou, Ioannis ^{[16
,17
]}

Brunel, Philippe ^{[18
]}

Lansky, Alexandra ^{[19
]}

Meerkin, David ^{[20
]}

Legrand, Victor ^{[21
]}

Medina, Alfonso ^{[22
]}

Lefevre, Thierry ^{[1
]}

机构：

[1] Inst Cardiovasc Paris Sud, Massy, France

[2] Kings Coll Hosp London, BCIS, London, England

[3] Univ Toronto, Univ Hlth Network, Toronto, ON, Canada

[4] Brighton & Sussex Univ Hosp, NHS Trust, Brighton, E Sussex, England

[5] Univ Catania, Ferrarotto Hosp, Clin Div Cardiol, Cardiac Catheterizat & Intervent Cardiol Unit, Catania, Italy

[6] Reina Sofia Hosp, Serv Cardiol, Cordoba, Spain

[7] Univ Cattolica Sacro Cuore, Inst Cardiol, I-00168 Rome, Italy

[8] Inst Clin & Expt Med, Dept Cardiol, Prague, Czech Republic

[9] Jagiellonian Univ, Coll Med, Inst Cardiol, Dept Intervent Cardiol, Krakow, Poland

[10] Univ Hosp Birmingham Trust, Queen Elizabeth Hosp, Birmingham, W Midlands, England

[11] Univ Turin, San Giovanni Battista Hosp, Intervent Cardiol Dept, Turin, Italy

[12] Aarhus Univ Hosp, Dept Cardiol, Skejby, Denmark

[13] Clin St Augustin, Intervent Cardiol Dept, Bordeaux, France

[14] German Heart Ctr, Dept Cardiovasc Dis, D-8000 Munich, Germany

[15] Med Klin 2, Erlangen, Germany

[16] Army Hosp Thessaloniki, Thessaloniki, Greece

[17] Blue Cross Heart Ctr, Thessaloniki, Greece

[18] Nouvelles Clin Nantaises, USCI, Nantes, France

[19] Columbia Univ, Med Ctr, Angiograph Core Lab, Cardiovasc Res Fdn, New York, NY USA

[20] Hadassah Hebrew Univ, Med Ctr, Dept Cardiol, Jerusalem, Israel

[21] CHU Liege, Serv Cardiol, Liege, Belgium

[22] Univ Hosp Dr Negrin, Dept Cardiol, Las Palmas Gran Canaria, Spain

来源：

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS | 2008年 / 71卷 / 02期

关键词：

bifurcation lesions; QCA; classification of bifurcation lesions; classification of treatments;

D O I：

10.1002/ccd.21314

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Percutaneous coronary intervention (PCI) of coronary bifurcation lesions remains a subject of debate. Many studies have been published in this setting. They are often small scale and display methodological flaws and other shortcomings such as inaccurate designation of lesions, heterogeneity, and inadequate description of techniques implemented. Methods: The aim is to propose a consensus established by the European Bifurcation Club (EBC), on the definition and classification of bifurcation lesions and treatments implemented with the purpose of allowing comparisons between techniques in various anatomical and clinical settings. Results: A bifurcation lesion is a coronary artery narrowing occurring adjacent to, and/or involving, the origin of a significant side branch. The simple lesion classification proposed by Medina has been adopted. To analyze the outcomes of different techniques by intention to treat, it is necessary to clearly define which vessel is the distal main branch and which is (are) the side branche(s) and give each branch a distinct name. Each segment of the bifurcation has been named following the same pattern as the Medina classification. The classification of the techniques (MADS: Main, Across, Distal, Side) is based on the manner in which the first stent has been implanted. A visual presentation of PCI techniques and devices used should allow the development of a software describing quickly and accurately the procedure performed. Conclusion: The EBC proposes a new classification of bifurcation lesions and their treatments to permit accurate comparisons of well described techniques in homogeneous lesion groups. (C) 2008 Wiley-Liss, Inc.

引用

页码：175 / 183

页数：9

共 68 条

[1]

AIROLDI F, 2005, JACC SA, V45

[2] Immediate and long-term outcome of intracoronary stent implantation for true bifurcation lesions [J].