Timi flow classification5/28/2023 ![]() ![]() JACC Cardiovasc Interv 2008 1:218-26.įor example, a lesion involving the proximal and distal MB without any SB involvement is classified as Medina “1,1,0”. Reproduced with permission from Latib et al. Medina Classification for Coronary Bifurcation Lesions. The Medina classification assesses plaque burden based on the presence (“1”) or absence (“0”) of stenosis in the proximal MB, distal MB, and SB (Figure 1). The simplest and most widely used is the Medina classification. Numerous classification schemes have been proposed to characterize coronary bifurcation lesions. The European Bifurcation Club defines a bifurcation lesion as a significant stenosis (i.e., >50%) in a coronary artery adjacent to and/or involving the origin of an SB that is clinically significant. The carina is the inflection point at which the proximal MB bifurcates into the distal MB and SB. Characterizing bifurcation lesions involves assessing the lesion morphology in three important anatomic segments: (1) proximal main branch (MB) (2) distal MB and (3) side branch (SB). A coronary bifurcation lesion occurs at or near a division of a major coronary artery. ![]()
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