Bifurcation classification schemes: impact of lesion morphology on development of a treatment strategy.
A number of bifurcation lesion classification schemes exist in which capital letters or Roman numerals categorize various types of bifurcation lesions. Unfortunately, these classification schemes are confusing and difficult to remember because of the lack of association between the numbers or letters and various anatomic abnormalities of bifurcation lesions. Recently, the Medina classification was proposed as a simpler, easier-to-remember scheme that labels bifurcation lesions by plaque involvement in 3 anatomic segments (proximal main segment, distal segment of main branch, and side branch). However, this classification also has limitations because it doesn't include important descriptive features of bifurcation lesions that could be important in determining optimum stent treatment strategy. The Movahed classification overcomes these limitations by including bifurcation angle and proximal vessel size in its scheme. The impact of these various classification schemes on stent treatment strategies and more recent clinical trial results is discussed.
Sanborn
Timothy A
TA
Division of Cardiology, Department of Medicine, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000145:classification* / Q000175:diagnosis / Q000628:therapy; D019317:Evidence-Based Medicine; D006801:Humans; D018579:Patient Selection; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D015607:Stents; D009626:Terminology as Topic; D016896:Treatment Outcome