Clinical Outcome After DK Crush Versus Culotte Stenting of Distal Left Main Bifurcation Lesions

Chen, Shao‐Liang; Xu, Bo; Han, Yaling; Sheiban, Imad; Zhang, Junjie; Ye, Fei; Kwan, Tak; Paiboon, Chitprapai; Zhou, Yujie; Liu, Shuzheng; Dangas, George; Xu, Yawei; Wen, Shimin; Liu, Hong; Zhang, Ruiyan; Wang, Haichang; Jiang, Tieming; Yan, Wei; Sansoto, Teguh; Chen, Fang; Yuan, Zuyi; Liu, Weimin; Leon, Martin B.

doi:10.1016/j.jcin.2015.05.017

Cited by 143 publications

(116 citation statements)

References 26 publications

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“…In the NORDIC stent technique study with first-generation DES, 15 the 3-year incidence of definite stent thrombosis following culotte stenting was 4.7% and it was 3.4% in the DKCRUSH-III trial with new-generation DES. 16 TAP stenting is currently the preferred approach of side-branch stenting with the recommended strategy of provisional side-branch stenting. Thus far, culotte stenting has only been compared with two crush stenting techniques that are not compatible with the strategy of provisional side-branch stenting.…”

Section: Discussionmentioning

confidence: 99%

Culotte stenting vs. TAP stenting for treatment of de-novo coronary bifurcation lesions with the need for side-branch stenting: the Bifurcations Bad Krozingen (BBK) II angiographic trial

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Culotte stenting vs. TAP stenting for treatment of de-novo coronary bifurcation lesions with the need for side-branch stenting: the Bifurcations Bad Krozingen (BBK) II angiographic trial

et al. 2016

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“…The Nordic II study showed that definite ST was lower in the crush (1.4%) versus the culotte group (4.7%) respectively; however, this did not reach statistical significance ( P = 0.09) . The DKCRUSH‐III study reported a significantly increased definite ST rate (3.4%) in the culotte group versus DK crush group (0%; P = 0.007) . The Milan and New‐Tokyo (MITO) registry also showed that definite ST occurred significantly higher (6.3 vs. 0%, P = 0.02) in the culotte group versus mini‐Crush group .…”

Section: Discussionmentioning

confidence: 99%

Definite stent thrombosis after drug‐eluting stent implantation in coronary bifurcation lesions: A meta‐analysis of 3,107 patients from 14 randomized trials

Zhou

Chen

Huang

et al. 2017

Cathet Cardio Intervent

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“…[22][23][24] In left main bifurcation, lesions culotte technique has compared favorably with the provisional strategy but was associated with increased major adverse cardiac event (mainly because of increased target vessel revascularization) when compared with the DK crush technique. 21,25,26 The 2 kissing balloon inflations intrinsic to the DK crush technique may improve ostial SB stent apposition resulting in less restenosis. In our trial, quantative coronary analysis in the culotte group showed greater acute gain in both the SB and the MB, possibly because of less stent distortion in the MB and less recoil in the SB.…”

Section: Discussionmentioning

confidence: 99%

The EBC TWO Study (European Bifurcation Coronary TWO)

Hildick‐Smith

Behan²,

Lassen

et al. 2016

Circ: Cardiovascular Interventions

105

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T reatment of bifurcation coronary lesions remains a difficult area, in which best practice is yet to be fully established. Randomized trials of all-comer bifurcation lesions have demonstrated that there is no advantage to systematic dual drugeluting stent strategies. However, these trials included a high proportion of patients with no disease in the side branch (SB) or relatively small SB vessels. 1-10 See Editorial by De LucaExpert consensus suggests that large caliber bifurcation lesions with significant ostial SB disease probably warrant an upfront 2-stent strategy, but this consensus has not been tested.11 This trial was designed to assess the hypothesis that large true bifurcations with significant SB ostial disease are Background-For the treatment of coronary bifurcation lesions, a provisional strategy is superior to systematic 2-stent techniques for the most bifurcation lesions. However, complex anatomies with large side branches (SBs) with significant ostial disease length are considered by expert consensus to warrant a 2-stent technique upfront. This consensus view has not been scientifically assessed. Methods and Results-Symptomatic patients with large caliber true bifurcation lesions (SB diameter ≥2.5 mm) and significant ostial disease length (≥5 mm) were randomized to either a provisional T-stent strategy or a dual stent culotte technique. Two hundred patients aged 64±10 years, 82% male, were randomized in 20 European centers. The clinical presentations were stable coronary disease (69%) and acute coronary syndromes (31%). SB stent diameter (2.67±0.27 mm) and length (20.30±5.89 mm) confirmed the extent of SB disease. Procedural success (provisional 97%, culotte 94%) and kissing balloon inflation (provisional 95%, culotte 98%) were high. Sixteen percent of patients in the provisional group underwent T-stenting. The primary end point (a composite of death, myocardial infarction, and target vessel revascularization at 12 months) occurred in 7.7% of the provisional T-stent group versus 10.3% of the culotte group (hazard ratio, 1.02; 95% confidence interval, 0.78-1.34; P=0.53). Procedure time, x-ray dose, and cost all favored the simpler procedure. Conclusions-When treating complex coronary bifurcation lesions with large stenosed SBs, there is no difference between a provisional T-stent strategy and a systematic 2-stent culotte strategy in a composite end point of death, myocardial infarction, and target vessel revascularization at 12 months. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT 01560455.(Circ Cardiovasc Interv. 2016;9:e003643.

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Clinical Outcome After DK Crush Versus Culotte Stenting of Distal Left Main Bifurcation Lesions

Cited by 143 publications

References 26 publications

Culotte stenting vs. TAP stenting for treatment of de-novo coronary bifurcation lesions with the need for side-branch stenting: the Bifurcations Bad Krozingen (BBK) II angiographic trial

Culotte stenting vs. TAP stenting for treatment of de-novo coronary bifurcation lesions with the need for side-branch stenting: the Bifurcations Bad Krozingen (BBK) II angiographic trial

Definite stent thrombosis after drug‐eluting stent implantation in coronary bifurcation lesions: A meta‐analysis of 3,107 patients from 14 randomized trials

The EBC TWO Study (European Bifurcation Coronary TWO)

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