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The plaque distribution


European Bifurcation Club 2011, EBC 2011 – Lisbon, Portugal


The plaque distribution

AuthorCorrado Tamburino, MD, Ferrarotto Hospital, University of Catania, Italy



  • Its impact may not be dependent on stent technique (differently from bifurcation angle).
  • It allows for a tailored treatment of the bifurcation segments potentially influencing outcomes, allowing to avoid “overtreatment or undertreatment”.
  • It is a marker of progression disease pattern.


  • Retrospective not pre-specified design
  • Although plaque distribution pattern resulted to predict TLR regardless of the performed stent technique, the impact of this latter factor should be better evaluated in a larger population with a pre-specified design.
  • IVUS plaque distribution assessment was not performed


  • Plaque distribution“perse”,therefore regardless of the adopted classification system, may and be useful to discriminate the “good from the bad bifurcation” and to drive treatment strategy (PCI or CABG? Stent technique?).
  • Characterization of plaque distribution by IVUS is the most proper, in particular in critical sites as LM. However, there is a need for more practical tools based on angiography.
  • Large studies evaluating the prognostic value of plaque distribution and validating classification system based on it are needed


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