Evaluation of coronary bifurcational lesions by the lesion symmetry and referred diameter of branches.

Objective The purpose of the study is to establish a novel classification criterion for coronary bifurcational lesions.Methods The coronary bifurcational lesions were classified according to the lesion symmetry and the referred diameter of branches.Based on this classification,the intervention principle was then designed.First,the bifurcational lesions were divided into the dominant and the equivalent branch based on the referred diameter of the branches.Second,the bifurcational lesions were divided into the symmetrical and non-symmetrical type according to the character of the lesions.Third,the non-symmetry and dominant branch bifurcation lesions were divided into subtype A (lesion in dominant branch) and B (lesion in non-dominant branch).Forth,double stent and kissing technique were used in symmetry and equivalent branch bifurcations and the single stent technique in other bifurcations.Results 300 patients with bifurcational lesions were divided into the traditional (Lefevre group)and novel group(ERDALS group),each having 150 cases.Though all the procedure was successfully performed in both groups,the novel group achieved a lower rate of stent implantation (1.2% vs 1.7%,P0.05),shorter procedure time [(15.3±4.2)min vs(21.6±5.4)min,P0.05)] and less major adverse cardiac events (1.3% vs 3.3%,P0.05) when compared with the traditional group.Conclusion The novel classification of coronary bifurcation by the lesion symmetry and branch referred diameter was of value to the selection of stent strategy in treating the coronary bifurcational lesions.