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Review
. 2025 Jan;21(1):31-37.
doi: 10.1080/14796678.2024.2444156. Epub 2024 Dec 23.

The shortcomings of the Medina compared to the Movahed coronary bifurcation classification

Mohammad Reza Movahed  1   2
Affiliations
Review

The shortcomings of the Medina compared to the Movahed coronary bifurcation classification

Mohammad Reza Movahed. Future Cardiol. 2025 Jan.

Abstract

The Medina classification separates true bifurcation lesions into three unnecessary groups: 1.1.1, 1.0.1, and 0.1.1. Non-true bifurcation lesions are divided into three unnecessary subgroups called 0.0.1, 0.1.0, and 1.0.0. Furthermore, the Medina classification does not describe any other important features of a given bifurcation lesion, making it useless when comparing complex bifurcation lesions. This has led to confusion in clinical settings and stagnation of bifurcation research. The Movahed bifurcation classification has overcome those problems by summarizing all true bifurcation lesions into one simple relevant category called B2 (B for bifurcation, 2 meaning both main and side branches at bifurcation site have significant lesions) and non-true bifurcation lesions into two simple categories called B1m (B for bifurcation, 1 m meaning only the main branch has significant lesion) and B1S lesions (B for bifurcation and 1 s meaning only the side branch has significant lesion). Moreover, at the same time, additional unlimited suffixes can be added if needed to describe a given bifurcation lesion, making this bifurcation also very comprehensive. In this perspective, the shortcomings of the Medina classification compared to the Movahed classification are discussed in detail.

Keywords: Coronary bifurcation; PCI; angioplasty; atherosclerosis; bifurcation; coronary bifurcation classification; percutaneous coronary intervention; stenting.

Plain language summary

Coronary bifurcation lesion means that coronary trees have significant disease at the site of two coronary branches. This perspective discusses the Movahed classification, which is easier to remember and is more comprehensive in describing atherosclerotic disease involvement of a given coronary bifurcation disease compared to the Medina classification.

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Conflict of interest statement

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

References

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    2. •• Very important review of bifurcation classification and intervention based on the Movahed classification.

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