Clinical and morphological evaluation of coronary bifurcation lesions

OBJECTIVES
We aimed to investigate the anatomical and morphological characterization of coronary bifurcation lesions.

STUDY DESIGN
The study population consisted of 542 stable patients who underwent coronary angiography. Bifurcation lesions were defined as a lesion ≥50% diameter stenosis involving a main branch and/or contiguous side branch with a diameter of ≥2.5 mm. Using these criteria, the presence and number of bifurcation lesions, bifurcation lesion location, lesion classification according to Medina classification and the angle of the bifurcation lesion were determined.

RESULTS
According to the bifurcation definition 19.3% (n=105) of our patients had bifurcation lesions. In 77% of all bifurcation lesions, the bifurcation angle was <70°. About 37% of all lesions were concordant with the Medina 1.1.1 classification. Approximately 56% of bifurcation lesions were in the LAD region, 25.4% in the Cx region, and 12.5% in the RCA region. Medina 1.1.1 was the most frequently observed in the LAD and RCA regions, while it was least common in the Cx and LMCA regions. Diabetes was observed to be significantly higher in those with bifurcation lesions than in those without.

CONCLUSION
Bifurcation lesions are frequently observed in coronary angiography practice. Angiographic characteristics and the relationship of these lesions with clinical conditions may be a crucial factor in choosing the appropriate interventional procedure.