Evaluation of a Strategy for Treating Bifurcated Lesions by Single or Double Stenting Based on the Medina Classification

• Published in: Revista española de cardiología (English ed.) 2009-06, Vol.62 (6), p.606-614
• Main Authors: Todaro, Daniel, Burzotta, Francesco, Trani, Carlo, Brugaletta, Salvatore, De Vita, Maria, Talarico, Giovanni P., Giammarinaro, Maura, Porto, Italo, Leone, Antonio Maria, Niccoli, Giampaolo, Mongiardo, Rocco, Mazzari, Mario Attilio, Schiavoni, Giovanni, Crea, Filippo
• Format: Article
• Language: English
• Subjects: Angioplastia coronaria transluminal percutánea; Bifurcated lesion classification; Clasificación de lesiones bifurcadas; Drugeluting stent; Medina; Percutaneous transluminal coronary angioplasty; Stent; Stent liberador de fármacos
• ISSN: 1885-5857; 1885-5857
• DOI: 10.1016/S1885-5857(09)72224-8

The Medina bifurcated lesion classification has been widely adopted because of its simplicity. However, no data are available on its use in helping select the best stenting technique for bifurcations. Consecutive patients with bifurcated lesions (side branch ≥2.25 mm) were prospectively assessed using the Medina classification. The treatment strategy studied involved implanting two stents in lesions with a Medina classification of 1,1,1 (M3 group) and one stent in only the main vessel in lesions with other Medina classifications (OM group). Clinical endpoints were a major adverse cardiac event (MACE) and target lesion revascularization (TLR) during hospitalization and at 12-month follow-up. The study included 120 patients: 25 in the M3 group and 95 in the OM group. There was no difference in baseline characteristics between the groups. The treatment strategy was successfully implemented in 97% of the OM group and 68% of the M3 group ( P