Long‐term outcomes of bifurcation lesions after implantation of drug‐eluting stents with the “mini‐crush technique”

Galassi, Alfredo R.; Colombo, Antonio; Buchbinder, Maurice; Grasso, Carmelo; Tomasello, Salvatore D.; Ussia, Gian Paolo; Tamburino, Corrado

doi:10.1002/ccd.21047

Cited by 72 publications

(46 citation statements)

References 23 publications

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“…In registries and a randomized trial, restenosis rates of 12% to 28% have been reported after crush stenting. 5,19 Our in-segment restenosis rate of 12.1% compares favorably with these results, possibly because there was a per protocol kissing balloon postdilatation. A final kissing balloon dilatation has been related to low restenosis rates in bifurcation lesions using crush and other bifurcation stenting techniques.…”

Section: Erglis Et Al Crush Vs Culotte Bifurcation Stenting Techniquesupporting

confidence: 65%

“…There were more patients with significant stenosis in both MV and SB, ie, a "true" bifurcation lesion (Medina classification 1,1,1; 1,0,1; 0,1,1), 19 in the culotte group than in the crush group (82.3% versus 73.3%, Pϭ0.03). The SB had no significant stenosis in 13.0% of crush patients versus 18.6% of culotte patients (ns).…”

Section: Erglis Et Al Crush Vs Culotte Bifurcation Stenting Technique 29mentioning

confidence: 99%

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Randomized Comparison of Coronary Bifurcation Stenting With the Crush Versus the Culotte Technique Using Sirolimus Eluting Stents

Ērglis

Kumsārs

Niemelä

et al. 2009

Circ: Cardiovascular Interventions

153

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Background-In a number of coronary bifurcation lesions, both the main vessel and the side branch need stent coverage.Using sirolimus eluting stents, we compared 2 dedicated bifurcation stent techniques, the crush and the culotte techniques in a randomized trial with separate clinical and angiographic end-points. Methods and Results-A total of 424 patients with a bifurcation lesion were randomized to crush (nϭ209) and culotte (nϭ215) stenting. The primary end point was major adverse cardiac events; cardiac death, myocardial infarction, target vessel revascularization, or stent thrombosis after 6 months. At 6 months there were no significant differences in major adverse cardiac event rates between the groups; crush 4.3%, culotte 3.7% (Pϭ0.87). Procedure and fluoroscopy times and contrast volumes were similar in the 2 groups. The rates of procedure-related increase in biomarkers of myocardial injury were 15.5% in crush versus 8.8% in culotte group (Pϭ0.08). A total of 324 patients had a quantitative coronary assessment at the index procedure and after 8 months. The angiographic end-points of in-segment and in-stent restenosis of main vessel and/or side branch after 8 months were found in 12.1% versus 6.6% (Pϭ0.10) and in 10.5% versus 4.5% (Pϭ0.046) in the crush and culotte groups, respectively. Conclusions-Both the crush and the culotte bifurcation stenting techniques were associated with similar and excellent clinical and angiographic results. Angiographically, there was a trend toward less in-segment restenosis and significantly reduced in-stent restenosis following culotte stenting. (Circ Cardiovasc Intervent. 2009;2:27-34.)

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Section: Erglis Et Al Crush Vs Culotte Bifurcation Stenting Techniquesupporting

confidence: 65%

Section: Erglis Et Al Crush Vs Culotte Bifurcation Stenting Technique 29mentioning

confidence: 99%

Randomized Comparison of Coronary Bifurcation Stenting With the Crush Versus the Culotte Technique Using Sirolimus Eluting Stents

Ērglis

Kumsārs

Niemelä

et al. 2009

Circ: Cardiovascular Interventions

153

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“…Bifurcation lesions were treated by using one of the following strategies at the operator's discretion: provisional T-stenting, T-stenting, V-stenting, or mini-crush stenting. 5 Interventional strategy and administration of glycoprotein IIb/IIIa inhibitors were left to the discretion of the operators. Glycoproteins IIb/IIIa were used in 36.7% of patients.…”

Section: Patient Populationmentioning

confidence: 99%

Usefulness of the SYNTAX Score for Predicting Clinical Outcome After Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery Disease

Capodanno

Salvo

Cincotta

et al. 2009

Circ: Cardiovascular Interventions

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203

158

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Background-The SYNTAX score (SXscore) has been proposed recently as a valuable tool to characterize the coronary vasculature prospectively with respect to the number of lesions and their functional impact, location, and complexity. However, the prognostic value of SXscores in patients undergoing percutaneous coronary intervention of the left main artery has not been validated. Methods and Results-We applied the SXscore in 255 consecutive patients who underwent percutaneous coronary intervention for left main disease and explored its performance with respect to their clinical outcome. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate the relation between the SXscore and the incidence of cardiac mortality, the primary end point of the study, and major adverse cardiac events (MACE

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“…The techniques named ''modified balloon Crush'' [57], ''double kissing crush'' [58],''sleeve technique'' [59] are other variants of the Crush technique. When the SB stent is crushed on a short segment, the best denomination seems to be ''minicrush'' as described by Galassi et al [60] compared to modified T stenting as described by Kobayashi et al [49].…”

Section: Definition and Denomination Of Coronary Bifurcation Lesion Tmentioning

confidence: 99%

Classification of coronary artery bifurcation lesions and treatments: Time for a consensus!

Louvard

Thomas

Džavík

et al. 2007

Cathet Cardio Intervent

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269

139

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Background: Percutaneous coronary intervention (PCI) of coronary bifurcation lesions remains a subject of debate. Many studies have been published in this setting. They are often small scale and display methodological flaws and other shortcomings such as inaccurate designation of lesions, heterogeneity, and inadequate description of techniques implemented. Methods: The aim is to propose a consensus established by the European Bifurcation Club (EBC), on the definition and classification of bifurcation lesions and treatments implemented with the purpose of allowing comparisons between techniques in various anatomical and clinical settings. Results: A bifurcation lesion is a coronary artery narrowing occurring adjacent to, and/or involving, the origin of a significant side branch. The simple lesion classification proposed by Medina has been adopted. To analyze the outcomes of different techniques by intention to treat, it is necessary to clearly define which vessel is the distal main branch and which is (are) the side branche(s) and give each branch a distinct name. Each segment of the bifurcation has been named following the same pattern as the Medina classification. The classification of the techniques (MADS: Main, Across, Distal, Side) is based on the manner in which the first stent has been implanted. A visual presentation of PCI techniques and devices used should allow the development of a software describing quickly and accurately the procedure performed. Conclusion: The EBC proposes a new classification of bifurcation lesions and their treatments to permit accurate comparisons of well described techniques in homogeneous lesion groups. '

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Long‐term outcomes of bifurcation lesions after implantation of drug‐eluting stents with the “mini‐crush technique”

Cited by 72 publications

References 23 publications

Randomized Comparison of Coronary Bifurcation Stenting With the Crush Versus the Culotte Technique Using Sirolimus Eluting Stents

Randomized Comparison of Coronary Bifurcation Stenting With the Crush Versus the Culotte Technique Using Sirolimus Eluting Stents

Usefulness of the SYNTAX Score for Predicting Clinical Outcome After Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery Disease

Classification of coronary artery bifurcation lesions and treatments: Time for a consensus!

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