title: Classification of coronary artery bifurcation lesions and treatments: time for a consensus!
abstract: 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.
  
  
  CONCLUSIONS
  The EBC proposes a new classification of bifurcation lesions and their treatments to permit accurate comparisons of well described techniques in homogeneous lesion groups.
authors.affiliation: Institut Cardiovasculaire Paris Sud, Massy, France. y.louvard@icps.com.fr
authors.forename: Yves
authors.initials: Y
authors.lastname: Louvard
authors.forename: Martyn
authors.initials: M
authors.lastname: Thomas
authors.forename: Vladimir
authors.initials: V
authors.lastname: Dzavik
authors.forename: David
authors.initials: D
authors.lastname: Hildick-Smith
authors.forename: Alfredo R
authors.initials: AR
authors.lastname: Galassi
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.forename: Francisco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Michael
authors.initials: M
authors.lastname: Zelizko
authors.forename: Darius
authors.initials: D
authors.lastname: Dudek
authors.forename: Peter
authors.initials: P
authors.lastname: Ludman
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.forename: Jens F
authors.initials: JF
authors.lastname: Lassen
authors.forename: Olivier
authors.initials: O
authors.lastname: Darremont
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Josef
authors.initials: J
authors.lastname: Ludwig
authors.forename: Ioannis
authors.initials: I
authors.lastname: Iakovou
authors.forename: Philippe
authors.initials: P
authors.lastname: Brunel
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lansky
authors.forename: David
authors.initials: D
authors.lastname: Meerkin
authors.forename: Victor
authors.initials: V
authors.lastname: Legrand
authors.forename: Alfonso
authors.initials: A
authors.lastname: Medina
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography / Q000592:standards; D023921:Coronary Stenosis / Q000145:classification* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D019919:Prosthesis Implantation / Q000379:methods*; D015607:Stents; D009626:Terminology as Topic