Modified flower petal technique in the treatment of Medina type 0,0,1 or 0,1,0 lesions

Abstract

Aims: The optimal strategy for patients with isolated ostial bifurcation lesions has not yet been determined. We propose the modified flower petal technique for the treatment of Medina type 0,0,1 or 0,1,0 coronary bifurcation lesions. Methods and results: We selected 64 patients who had Medina type 0,0,1 or 0,1,0 coronary bifurcation lesions. Percutaneous coronary intervention (PCI) was performed with the modified flower petal technique in all patients. After PCI, all patients were followed up to nine months after the intervention. Quantitative coronary angiography (QCA) analyses were performed for both the main and the side branch at baseline, after the stent implantation and at nine-month follow-up. Twenty patients (31.2%) had ostial left anterior descending artery lesions, nine patients (14.1%) had ostial circumflex artery lesions and the other patients had isolated ostial non-left main bifurcation lesions. The procedural success rate was 100%. There was no death, myocardial infarction, subacute or late stent thrombosis at nine-month follow-up. In one patient, in-stent restenosis requiring reintervention was noted. Conclusions: The modified flower petal technique has excellent acute results and midterm clinical outcomes in the management of Medina type 0,0,1 or 0,1,0 coronary bifurcation lesions.