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. 2023 Dec 4;19(10):e807–e831. doi: 10.4244/EIJ-E-22-00018

Table 2. Complexity definition of bifurcation lesions according to diagnostic technique.

Category
A Angiography B Intravascular imaging C Coronary CT
1) True bifurcation lesions (MEDINA 1,1,1; 1,0,1; 0,1,1)94 + 1 of the following: • SB disease length ≥10 mm95,96,97 • Calcified lesion • Thrombotic lesion • Difficult SB access (higher risk if bifurcation angle A <90°) 2) RESOLVE score98 Dedicated bifurcation QCA recommended 1) True bifurcation lesions (MEDINA 1,1,1; 1,0,1; 0,1,1)94 +1 of the following: • SB disease length ≥10 mm99,100,101 • Thrombotic lesion • Calcium arc >60° at the culprit lesion site99 • Difficult SB access (higher risk if bifurcation angle A <90°)a 1) True bifurcation lesions (MEDINA 1,1,1; 1,0,1; 0,1,1)94 +1 of the following: • SB disease length ≥10 mm99,100,101 • Thrombotic lesion • Calcium arc >60° at the culprit lesion site99 • Difficult SB access (higher risk if bifurcation angle A <90° [3D assessment]) • Plaque composition: presence of low attenuation plaque in the SB or spotty calcifications within the bifurcation lesion100 • Abnormal CT-derived FFR in the SB, suggesting dedicated 2-stent strategy 2) CT bifurcation score >1101: • Ca-plaque in PMV (+1) • Low attenuation plaque in PMV/SB (+1) • SB lesion length >5 mm (+1) • MV area/SB area >4.3 (+1) 3) CT-derived RESOLVE SCORE102
aAngiography based. Ca: calcium; CT: computed tomography; FFR: fractional flow reserve; QCA: quantitative coronary analysis; other abbreviations as in Table 1.