Francesco Burzotta1, Jens Flensted Lassen2, Yves Louvard3, Thierry Lefèvre3, Adrian P Banning4, Olivier Daremont5, Manuel Pan6, David Hildick-Smith7, Alaide Chieffo8, Yiannis S Chatzizisis9, Vladimír Džavík10, Hyeon-Cheol Gwon11, Yutaka Hikichi12, Yoshinobu Murasato13, Bon Kwon Koo14, Shao-Liang Chen15, Patrick Serruys16, Goran Stankovic17. 1. Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 2. Department of Cardiology B, Odense Universitetshospital and University of Southern Denmark, Odense, Denmark. 3. Ramsay Générale de Santé-Institut cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Massy, France. 4. Cardiovascular Medicine Division, Radcliffe Department of Medicine, John Radcliffe Hospital, Oxford, UK. 5. Clinique St Augustin, Bordeaux, France. 6. Department of Cardiology, Reina Sofia Hospital, University of Cordoba (IMIBIC), Cordoba, Spain. 7. Sussex Cardiac Center and Sussex University Hospitals, Brighton, UK. 8. Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy. 9. Cardiovascular Division, University of Nebraska Medical Center, Omaha, Nebraska, USA. 10. Interventional Cardiology Program, Division of Cardiology, Toronto General Hospital, Toronto, Ontario, Canada. 11. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 12. Department of Cardiovascular Medicine, Saga University, Saga, Japan. 13. Department of Cardiology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. 14. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea. 15. Division of Cardiology, Nanjing First Hospital and Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaboratory Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China. 16. National Heart and Lung Institute, Imperial College London, London, UK. 17. Medical Faculty, Department of Cardiology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia.
Abstract
BACKGROUND: Defining the optimal conduction of percutaneous-coronary-intervention (PCI) to treat bifurcation lesions has been the subject of many clinical studies showing that the applied stenting technique may influence clinical outcome. Accordingly, bifurcation stenting classifications and technical sequences should be standardized to allow proper reporting and comparison. METHODS: The European Bifurcation Club (EBC) is a multidisciplinary group dedicated to optimize the treatment of bifurcations and previously created a classification of bifurcation stenting techniques that is based on the first stent implantation site. Since some techniques have been abandoned, others have been refined and dedicated devices became available, EBC promoted an international task force aimed at updating the classification of bifurcation stenting techniques as well as at highlighting the best practices for most popular techniques. Original descriptive images obtained by drawings, bench tests and micro-computed-tomographic reconstructions have been created in order to serve as tutorials in both procedure reporting and clinical practice. RESULTS: An updated Main-Across-Distal-Side (MADS)-2, classification of bifurcation stenting techniques has been realized and is reported in the present article allowing standardized procedure reporting in both clinical practice and scientific studies. The EBC-promoted task force deeply discussed, agreed on and described (using original drawings and bench tests) the optimal steps for the following major bifurcation stenting techniques: (a) 1-stent techniques ("provisional" and "inverted provisional") and (b) 2-stent techniques ("T/TAP," "culotte," and "DK-crush"). CONCLUSIONS: The present EBC-promoted paper is intended to facilitate technique selection, reporting and performance for PCI on bifurcated lesions during daily clinical practice.
BACKGROUND: Defining the optimal conduction of percutaneous-coronary-intervention (PCI) to treat bifurcation lesions has been the subject of many clinical studies showing that the applied stenting technique may influence clinical outcome. Accordingly, bifurcation stenting classifications and technical sequences should be standardized to allow proper reporting and comparison. METHODS: The European Bifurcation Club (EBC) is a multidisciplinary group dedicated to optimize the treatment of bifurcations and previously created a classification of bifurcation stenting techniques that is based on the first stent implantation site. Since some techniques have been abandoned, others have been refined and dedicated devices became available, EBC promoted an international task force aimed at updating the classification of bifurcation stenting techniques as well as at highlighting the best practices for most popular techniques. Original descriptive images obtained by drawings, bench tests and micro-computed-tomographic reconstructions have been created in order to serve as tutorials in both procedure reporting and clinical practice. RESULTS: An updated Main-Across-Distal-Side (MADS)-2, classification of bifurcation stenting techniques has been realized and is reported in the present article allowing standardized procedure reporting in both clinical practice and scientific studies. The EBC-promoted task force deeply discussed, agreed on and described (using original drawings and bench tests) the optimal steps for the following major bifurcation stenting techniques: (a) 1-stent techniques ("provisional" and "inverted provisional") and (b) 2-stent techniques ("T/TAP," "culotte," and "DK-crush"). CONCLUSIONS: The present EBC-promoted paper is intended to facilitate technique selection, reporting and performance for PCI on bifurcated lesions during daily clinical practice.
Authors: Antonios P Antoniadis; Peter Mortier; Ghassan Kassab; Gabriele Dubini; Nicolas Foin; Yoshinobu Murasato; Andreas A Giannopoulos; Shengxian Tu; Kiyotaka Iwasaki; Yutaka Hikichi; Francesco Migliavacca; Claudio Chiastra; Jolanda J Wentzel; Frank Gijsen; Johan H C Reiber; Peter Barlis; Patrick W Serruys; Deepak L Bhatt; Goran Stankovic; Elazer R Edelman; George D Giannoglou; Yves Louvard; Yiannis S Chatzizisis Journal: JACC Cardiovasc Interv Date: 2015-08-24 Impact factor: 11.195
Authors: Gary S Mintz; Thierry Lefèvre; Jens Flensted Lassen; Luca Testa; Manuel Pan; Jag Singh; Goran Stankovic; Adrian P Banning Journal: EuroIntervention Date: 2018-07-20 Impact factor: 6.534
Authors: Ilias Nikolakopoulos; Evangelia Vemmou; Judit Karacsonyi; Lorenzo Azzalini; Brian A Bergmark; Yiannis S Chatzizisis; Allison B Hall; Jason Wollmuth; Kevin Croce; Hani Jneid; Bavana V Rangan; M Nicholas Burke; Emmanouil S Brilakis Journal: J Invasive Cardiol Date: 2022-01 Impact factor: 2.022
Authors: Dobrin Vassilev; Niya Mileva; Carlos Collet; Pavel Nikolov; Katerina Sokolova; Kiril Karamfiloff; Vladimir Naunov; Jeroen Sonck; Gianluca Rigatelli; Ghassan S Kassab; Robert J Gil Journal: Sci Rep Date: 2021-12-21 Impact factor: 4.379
Authors: Francesco Burzotta; Jens Flensted Lassen; Thierry Lefèvre; Adrian P Banning; Yiannis S Chatzizisis; Thomas William Johnson; Miroslaw Ferenc; Sudhir Rathore; Remo Albiero; Manuel Pan; Olivier Darremont; David Hildick-Smith; Alaide Chieffo; Marco Zimarino; Yves Louvard; Goran Stankovic Journal: EuroIntervention Date: 2021-03-19 Impact factor: 6.534
Authors: Thomas F Valenzuela; Francesco Burzotta; Tinen L Iles; Jens F Lassen; Paul A Iaizzo Journal: Int J Cardiovasc Imaging Date: 2021-05-16 Impact factor: 2.357