EBC - ON DEMAND
The plaque distribution
European Bifurcation Club 2011, EBC 2011 – Lisbon, Portugal
LEFT MAIN SESSION
The plaque distribution
Author: Corrado Tamburino, MD, Ferrarotto Hospital, University of Catania, Italy
POTENTIAL ADVANTAGES
- 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.
LIMITATIONS
- 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
CONCLUSION
- 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