title: Modified flower petal technique: a new technique for the treatment of Medina type 1.1.1 coronary bifurcation lesions.
abstract: OBJECTIVE
  This study sought to propose a new technique for the treatment of Medina type 1.1.1 bifurcation lesions.
  
  
  BACKGROUND
  Although there are many different 2-stent techniques, the optimal strategy for patients with Medina type 1.1.1 bifurcation lesions has not yet been determined.
  
  
  METHODS
  The authors selected 30 patients who had Medina type 1.1.1 coronary bifurcation lesions. The most important characteristics of this new technique are complete coverage of the side branch (SB) ostium by stent struts and lower metallic burden at carina region. All procedures were performed using drug-eluting stents. All patients were followed up to 9 months after the intervention. Quantitative coronary angiography (QCA) analyses were performed for both the main and the side branches at baseline, after stent implantation, and at 9-month follow-up.
  
  
  RESULTS
  Procedural success rate was 100%. Final kissing balloon inflation could be performed in all patients. There was no major adverse cardiac events during hospital stay. Clinical and angiographic QCA follow-up was available in 28 patients (93.4%). There was no death, myocardial infarction, or stent thrombosis at 9 months follow-up. In-stent restenosis requiring reintervention was noted at the SB ostium in only 1 patient.
  
  
  CONCLUSIONS
  This new "modified flower petal" technique has several advantages for stent implantation of Medina type 1.1.1 bifurcation lesions over the available techniques: complete coverage of the SB ostium, lower metallic burden at the carina, and excellent immediate and midterm clinical outcomes.
authors.affiliation: Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey. drcayli@yahoo.com
authors.forename: Murat
authors.initials: M
authors.lastname: Çaylı
authors.forename: Durmuş Yıldıray
authors.initials: DY
authors.lastname: Şahin
authors.forename: Zafer
authors.initials: Z
authors.lastname: Elbasan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gür
authors.forename: Cağlar Emre
authors.initials: CE
authors.lastname: Çağlıyan
authors.forename: Ali
authors.initials: A
authors.lastname: Kıvrak
authors.forename: Taner
authors.initials: T
authors.lastname: Şeker
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ballı
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome