Comparison of intravascular ultrasound-guided with angiography-guided double kissing crush stenting for patients with complex coronary bifurcation lesions: Rationale and design of a prospective, randomized, and multicenter DKCRUSH VIII trial

Ge, Zhen; Kan, Jing; Gao, Xiaofei; Kong, Xiangquan; Zuo, Guang-Feng; Ye, Fei; Tian, Nai‐Liang; Lin, Song; Liu, Zhizhong; Sun, Zhiqi; He, Pengcheng; Wei, Lin; Yang, Wenming; He, Yuquan; Xue, Yu-Zeng; Wang, Lianmin; Miao, Li-fu; Pu, Jun; Sun, Ya-Wu; Nie, Shaoping; Jian-hong, Tao; Wen, Shimin; Yang, Qing; Su, Xi; Yao, Qi-Cheng; Huang, Yu‐Chen; Xia, Yong; Shen, Farong; Qiu, Chunguang; Mao, Youlin; Liu, Qiang; Hu, Xinqun; Du, Zhimin; Nie, Ruqiong; Han, Yaling; Zhang, Junjie; Chen, Shao‐Liang

doi:10.1016/j.ahj.2021.01.011

Cited by 12 publications

(12 citation statements)

References 30 publications

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“…Therefore, an intravascular imaging-guided stenting bifurcation is highly recommended. For this issue, two ongoing studies ( 28 , 29 ) would launch their results, demonstrating the advantage of intravascular imaging guidance in treating a bifurcation lesion.…”

Section: Discussionmentioning

confidence: 99%

Provisional stenting with side branch rescue stenting is associated with increased 3-year target lesion failure in patients with acute coronary syndrome and coronary bifurcation lesions

Sheiban

Kan

et al. 2022

Front. Cardiovasc. Med.

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BackgroundProvisional stenting (PS) is the main treatment for a majority of coronary bifurcation lesion and includes PS with 1-stent and PS with 2-stent. However, the treatment difference between PS with 1-stent and with 2-stent remains unclear in patients with the acute coronary syndrome (ACS) and coronary bifurcation lesions.Materials and methodsOverall, 820 ACS patients with Medina 1,1,1 or 0,1,1 coronary bifurcation lesion who had completed 3-year follow-up were included and assigned to the PS with 1-stent (n = 519) or the PS with 2-stent (n = 301) according to the use of final stenting technique. The primary endpoint was the target lesion failure (TLF) at 3 years since stenting procedures.ResultsAt 3-year follow-up, TLF occurred in 85 (16.4%) patients in the PS with 1-stent group and 69 (22.9%) in the PS with 2-stent group (hazard ratio [HR] 1.52, 95% confidence interval [CI] 1.06–2.17, p = 0.021), mainly driven by a higher rate of target lesion revascularization (TLR) in the PS with 2-stent group (13.0% vs. 8.3%, HR 1.65, 95% CI 1.04–2.61, p = 0.033). Complex bifurcations, side branch (SB) pretreatment, intravascular imaging guidance, and hyperlipidemia were the four predictors for 3-year TLF. SB pretreatment was associated with increased 3-year TLR, leading to an extremely higher 3-year TLF.ConclusionProvisional with 2-stent for patients with ACS is associated with a higher rate of 3-year TLF, mainly due to increased requirement of revascularization. SB pretreatment should be avoided for simple bifurcation lesion.

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Section: Discussionmentioning

confidence: 99%

Provisional stenting with side branch rescue stenting is associated with increased 3-year target lesion failure in patients with acute coronary syndrome and coronary bifurcation lesions

Sheiban

Kan

et al. 2022

Front. Cardiovasc. Med.

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“…The currently best-known proposed MSA cut-off values that predicted ISR are 5.0 mm 2 for LCx, 6.3 mm 2 for LAD, 7.2 mm 2 for confluence zone, and 8.2 mm 2 for LMCA [ 91 ]. However, nowadays some clinicians advocate for higher MSA thresholds, as in the DK-CRUSH VIII trial (>10 mm 2 , >7 mm 2 , >6 mm 2 for LMCA, LAD, and LCx, respectively) [ 92 ]. To sum up, IVUS is an important tool that can improve PCI performance, leading to fewer procedural-related complications and a better prognosis in patients with LMCAD.…”

Section: State-of-the-art Evaluation Of Lmcadmentioning

confidence: 99%

Left Main Coronary Artery Disease—Current Management and Future Perspectives

Dąbrowski

Kożuch

Dobrzycki

2022

JCM

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Due to its anatomical features, patients with an obstruction of the left main coronary artery (LMCA) have an increased risk of death. For years, coronary artery bypass grafting (CABG) has been considered as a gold standard for revascularization. However, notable advancements in the field of percutaneous coronary intervention (PCI) led to its acknowledgement as an important treatment alternative, especially in patients with low and intermediate anatomical complexity. Although recent years brought several random clinical trials that investigated the safety and efficacy of the percutaneous approach in LMCA, there are still uncertainties regarding optimal revascularization strategies. In this paper, we provide a comprehensive review of state-of-the-art diagnostic and treatment methods of LMCA disease, focusing on percutaneous methods.

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“…DK-CRUSH VIII is an ongoing randomized controlled trial for DK crush stenting using IVUS or angiographic guidance in 556 patients with complex bifurcation coronary lesions. [38] The results of this trial are eagerly awaited, as they have the potential to address critical questions regarding optimal DK crush stenting.…”

Section: Future Directionsmentioning

confidence: 99%

A Review of Double Kissing Crush Stenting in Coronary Bifurcation Lesions

Kwan

Lin

2022

Cardiology Discovery

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Double kissing (DK) crush stenting for coronary bifurcation lesions has gain popularity worldwide because of its superior randomized studies data and excellent clinical outcomes. This review evaluates all DK crush clinical trials and studies. It also reveals the contemporary technique steps by steps as well as the trouble shooting with illustrated clinical scenarios. Among all the available evidence, the DK crush technique is superior when compared to the provisional stenting technique for complex bifurcation lesion. DK crush stenting provides the best evidence-based approach to complex bifurcation lesions especially the left main coronary artery bifurcation lesions. Future direction of how to make this DK crush technique better is also proposed.

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Comparison of intravascular ultrasound-guided with angiography-guided double kissing crush stenting for patients with complex coronary bifurcation lesions: Rationale and design of a prospective, randomized, and multicenter DKCRUSH VIII trial

Cited by 12 publications

References 30 publications

Provisional stenting with side branch rescue stenting is associated with increased 3-year target lesion failure in patients with acute coronary syndrome and coronary bifurcation lesions

Provisional stenting with side branch rescue stenting is associated with increased 3-year target lesion failure in patients with acute coronary syndrome and coronary bifurcation lesions

Left Main Coronary Artery Disease—Current Management and Future Perspectives

A Review of Double Kissing Crush Stenting in Coronary Bifurcation Lesions

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