bifurcation lesion

bifurcation lesion

A term for an atherosclerotic lesion of the coronary arteries at a bifurcation.

Classification of bifurcation lesions
Y-shaped lesion
The angulation between side branch and main vessel is <70º; side branch access is usually easy, but plaque shift pronounced.

T-shaped lesion
Angle between side branch and main vessel is >70º; side branch access may be difficult, but plaque shift less pronounced.
 
Type 1–4 lesions
Type 1—True bifurcation lesion involving main vessel, proximal and distal to the side branch, and the ostium of the side branch.

Type 2—Bifurcation lesion involving main vessel proximal and distal to the side branch, but no involvement of side branch ostium.

Type 3—Bifurcation lesion involving main vessel proximal, but not distal to the side branch and without involvement of side branch ostium.
 
Type 4—Bifurcation lesion involving the distal main vessel and the ostium of the side branch.
      4a—Bifurcation lesion involving main vessel distal, but not proximal to the side branch and without involvement of side branch ostium.
      4b—Bifurcation lesion involving the side branch ostium only.
References in periodicals archive ?
Patients with left main coronary artery (LMCA) lesion (>50%), three-vessel disease (3VD) (>50%), left anterior descending artery diagonal I, diagonal II bifurcation lesion (>50%), proximal left anterior descending, and circumflex or right coronary artery 2-vessel disease (>50%) were included.
Yamazaki et al., "Three-dimensional optical frequency domain imaging of a true bifurcation lesion after stent implantation using the jailed semi-inflated balloon technique," SAGE Open Medical Case Reports, vol.
Clinical characteristics (n = 676 patients) Age (years) 63.4 [+ or -] 9.3 Female 194 (28.7) Hypertension 467 (69.1) Diabetes mellitus 181 (26.8) Previous myocardial infarction 369 (54.6) Atrial fibrillation 89 (13.1) Previous PCI 277 (41) Previous CABG 66 (9.8) Creatinine ([micro]mol/l) 84.3 [+ or -] 34.1 Procedural characteristics (n = 805 lesions) LM 15 (1.9) LAD 220 (27.3) Vessel treated Cx 257 (31.9) RCA 300 (37.3) SVG 13 (1.6) Ostial lesion 19 (2.4) Bifurcation lesion 75 (9.3) Number of stents implanted per 1.1 [+ or -] 0.34 lesion Total stent length per lesion (mm) 19.5 [+ or -] 9.4 Minimal stent diameter (mm) 3.01 [+ or -] 0.54 Predilatation 412 (51.2) Postdilatation 72 (8.9) Continuous variables are presented as the mean [+ or -] standard deviation.
[sup][1] Risk factors for SF include excessive tortuosity, angulation, bifurcation lesion or change in angulation following stent implantation of coronary vessels.
Patients' vessel lesions were considered 'complex' according to the previous studies [8],[9] when any of the following symptoms were present: ostial lesion, unprotected left main coronary artery lesion, bifurcation lesion, more than two vessels treated, lesion length >27 mm, totally occluded lesion (defined as the thrombolysis in myocardial infarction [TIMI] grade 0 flow and lasting ≥3 months), any lesion with thrombus, in-stent restenosis lesion, saphenous vein graft lesion, arterial bypass graft lesion, etc.
Multivariate Cox regression analysis indicated that the strategy of RA+CB was a significant protective factor against long-term (>1 year) in-stent restenosis ( HR : 0.136, 95% CI : 0.020-0.936, P = 0.043), after adjustment of age, gender, diabetes, hyperlipidemia, ostial lesion, bifurcation lesion, severe tortuosity, and lesions with severe calcification [Table 5].{Table 4}{Figure 2}{Table 5}
The lower angiographic restenosis rate in the bifurcation lesion after culotte stenting as compared with TAP stenting was also associated with lower rate of target lesion revascularisation (TLR) in the first year after PCI.
Long diffuse lesion, bifurcation lesion, and chronic total occlusion were identified in 128 (24.9%), 23 (4.5%), and 97 (18.9%) of 514 patients, respectively.
The variables tested in the multivariable models included age, gender, hypertension, diabetes, hypercholesterolemia, previous cerebrovascular accident, current smoker, MI history, anterior MI, single-vessel disease, ostial lesion, bifurcation lesion, total occlusion, type B2 or C lesion, preprocedural TIMI flow grade, postprocedural TIMI flow grade, number of stents per patient, diameter of stent, total stent length, IABP support, and thrombus aspiration and were selected by forward stepwise method.
Background: The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment.
We obtained quantitative angiographic measurements of the four segments of the bifurcation lesion: The proximal MV segment, the distal MV segment, the SB segment and the bifurcation core segment [Figure 2].
Five-year clinical follow-up of unprotected left main bifurcation lesion stenting: One-stent versus two-stent techniques versus double-kissing crush technique.