Comparison of Double Kissing Crush Versus Culotte Stenting for Unprotected 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; Wang, Yan; Chen, Fang; Yuan, Zuyi; Li, Weimin; Leon, Martin B.

doi:10.1016/j.jacc.2013.01.023

Cited by 190 publications

(129 citation statements)

References 20 publications

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“…621,622 In LM true bifurcation lesions, double-kissing crush has the most favourable outcome data. 623 Final 'kissing' balloon dilation is generally recommended when two stents are eventually required, with no advantage from final kissing with the one-stent technique. 624,625 Several stents, designed specifically for the treatment of bifurcation lesions, have undergone extensive evaluation with promising angiographic and clinical results, though RCTs against current recommended therapy are limited.…”

Section: Bifurcation Stenosismentioning

confidence: 99%

2018 ESC/EACTS Guidelines on myocardial revascularization

Neumann¹,

Ahlsson²,

Alfonso³

et al. 2018

European Heart Journal

4,714

1,703

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Section: Bifurcation Stenosismentioning

confidence: 99%

2018 ESC/EACTS Guidelines on myocardial revascularization

Neumann¹,

Ahlsson²,

Alfonso³

et al. 2018

European Heart Journal

4,714

1,703

View full text Add to dashboard Cite

“…This procedure is similar to the double-kiss crush technique, which has been shown to have better cardiac mortality outcomes compared with other 2-SS procedures such as culotte, traditional crush, V-stenting, and simultaneous kissing stent. 19 In this study, kissing balloon inflation was performed in 94.5% of patients undergoing a 2-SS, which was crucial for successful outcomes in the approach, with evidence of prognostic value. 20 In this study, all patients were treated for UDLM disease in only 3 high-volume centers by experienced cardiovascular interventionists who routinely treated UDLM disease using a 2-SS and IVUS.…”

Section: Discussionmentioning

confidence: 98%

Comparison Between 1- and 2-Stent Strategies in Unprotected Distal Left Main Disease

Takagi

Naganuma

Chieffo

et al. 2016

Circ: Cardiovascular Interventions

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Background— There are only little data available on the comparison of clinical outcomes between a 1-stent strategy (1-SS) and a 2-stent strategy (2-SS) for percutaneous coronary intervention in unprotected distal left main disease. Methods and Results— Between April 2005 and August 2011, we recruited 937 consecutive unprotected distal left main patients treated with drug-eluting stents (1-SS, 608 patients; 2-SS, 329 patients). Major adverse cardiovascular events were defined as all-cause death, myocardial infarction, or target lesion revascularization (TLR) during the median follow-up period of 1592 days. Furthermore, the individual components of major adverse cardiovascular events, cardiac death, and stent thrombosis were evaluated. More complex lesions were seen with 2-SS than with 1-SS. Cardiac death occurred more frequently with 1-SS than with 2-SS (propensity score–adjusted hazard ratio, 0.52; 95% confidence interval, 0.29–0.64; P =0.03), whereas TLR occurred more frequently with 2-SS than with 1-SS (propensity score–adjusted hazard ratio, 1.59; 95% confidence interval, 1.15–2.20; P =0.005). TLR was mainly driven by revascularizations after restenosis at the ostial left circumflex artery (propensity score–adjusted hazard ratio, 1.94; 95% confidence interval, 1.33–2.82; P =0.001). However, there were no differences in major adverse cardiovascular events, all-cause death, stent thrombosis, and myocardial infarction. Of the 139 pairs that were propensity score matched, only TLRs were significantly higher in the 2-SS group (hazard ratio, 1.59; 95% confidence interval, 1.00–2.53; P =0.05). Conclusions— The difference between 1-SS and 2-SS in percutaneous coronary intervention for unprotected distal left main disease may be summarized by the high incidence of TLR, mainly because of restenosis at the ostial left circumflex artery in the 2-SS group.

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“…Although there was no significant difference in the primary study endpoint of major adverse cardiac events, this trial showed a significantly reduced in-stent restenosis with culotte stenting as compared with crush stenting. The DKCRUSH-III trial 18 compared culotte stenting with the double-kissing crush technique in patients with unprotected distal left main stenosis. During 3-year follow-up, culotte stenting was associated with higher incidence of major adverse cardiac events including stent thrombosis.…”

Section: Discussionmentioning

confidence: 99%