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Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the "mini-crush technique".
Catheter Cardiovasc Interv. 2007 Jun 01; 69(7):976-83.CC

Abstract

OBJECTIVES

To evaluate clinical and angiographic long-term outcome of "the mini-crush" technique for treating bifurcation lesions.

BACKGROUND

Despite proven efficacy of drug-eluting stent (DES) within most lesions subsets, bifurcation lesions continue to exhibit high restenosis rate using current DES stenting technique.

METHODS

We report a new stenting technique which was employed in 45 consecutive patients (52 lesions) between April 2004 and July 2005 to treat true bifurcation lesions using DES in both branches.

RESULTS

Using this technique procedural success was obtained in 100% of cases, without complications and with excellent angiographic result in 96.1% and 98.1% of main vessel and side branch. Preprocedure reference vessel diameter and minimal lumen diameter (MLD) were 2.68 +/- 0.48 and 0.90 +/- 0.55 mm for the main branch, respectively and 2.28 +/- 0.34 and 1.14 +/- 0.47 mm for the side branch, respectively. Postprocedure MLD was 2.56 +/- 0.39 mm for the main branch and 2.16 +/- 0.29 mm for the side branch. There were no in-hospital major adverse cardiac events (MACE). At 72 days after procedure there was one case of side branch stent thrombosis (2.2%), which resulted in non Q-wave MI. Angiographic follow up was obtained in 100% of patients at 7.5 +/- 1.3 months. Target lesion revascularization (TLR) was 12.2%; no death and Q-wave MI were observed; reference vessel diameter and MLD for the main branch were 2.79 +/- 0.51 and 1.99 +/- 0.65 mm respectively and for the side branch 2.28 +/- 0.40 and 1.63 +/- 0.48 mm respectively. Restenosis rate in the main branch was 12.2% while in the side branch was 2.0%.

CONCLUSIONS

In-hospital outcome indicates that the mini-crush technique for bifurcation lesions with DES can be easily performed. It provides very low total MACE rate and restenosis at 8-month follow-up. These results confirmed the advantage of this specific technique to give complete coverage of the ostium of the side branch using two stents technique.

Authors+Show Affiliations

Department of Internal Medicine and Systemic Disease, Clinical Division of Cardiology, Ferrarotto Hospital, University of Catania, Italy. jimmanh2002@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17295334

Citation

Galassi, Alfredo R., et al. "Long-term Outcomes of Bifurcation Lesions After Implantation of Drug-eluting Stents With the "mini-crush Technique"." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 69, no. 7, 2007, pp. 976-83.
Galassi AR, Colombo A, Buchbinder M, et al. Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the "mini-crush technique". Catheter Cardiovasc Interv. 2007;69(7):976-83.
Galassi, A. R., Colombo, A., Buchbinder, M., Grasso, C., Tomasello, S. D., Ussia, G. P., & Tamburino, C. (2007). Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the "mini-crush technique". Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 69(7), 976-83.
Galassi AR, et al. Long-term Outcomes of Bifurcation Lesions After Implantation of Drug-eluting Stents With the "mini-crush Technique". Catheter Cardiovasc Interv. 2007 Jun 1;69(7):976-83. PubMed PMID: 17295334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the "mini-crush technique". AU - Galassi,Alfredo R, AU - Colombo,Antonio, AU - Buchbinder,Maurice, AU - Grasso,Carmelo, AU - Tomasello,Salvatore D, AU - Ussia,Gian P, AU - Tamburino,Corrado, PY - 2007/2/14/pubmed PY - 2007/7/14/medline PY - 2007/2/14/entrez SP - 976 EP - 83 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 69 IS - 7 N2 - OBJECTIVES: To evaluate clinical and angiographic long-term outcome of "the mini-crush" technique for treating bifurcation lesions. BACKGROUND: Despite proven efficacy of drug-eluting stent (DES) within most lesions subsets, bifurcation lesions continue to exhibit high restenosis rate using current DES stenting technique. METHODS: We report a new stenting technique which was employed in 45 consecutive patients (52 lesions) between April 2004 and July 2005 to treat true bifurcation lesions using DES in both branches. RESULTS: Using this technique procedural success was obtained in 100% of cases, without complications and with excellent angiographic result in 96.1% and 98.1% of main vessel and side branch. Preprocedure reference vessel diameter and minimal lumen diameter (MLD) were 2.68 +/- 0.48 and 0.90 +/- 0.55 mm for the main branch, respectively and 2.28 +/- 0.34 and 1.14 +/- 0.47 mm for the side branch, respectively. Postprocedure MLD was 2.56 +/- 0.39 mm for the main branch and 2.16 +/- 0.29 mm for the side branch. There were no in-hospital major adverse cardiac events (MACE). At 72 days after procedure there was one case of side branch stent thrombosis (2.2%), which resulted in non Q-wave MI. Angiographic follow up was obtained in 100% of patients at 7.5 +/- 1.3 months. Target lesion revascularization (TLR) was 12.2%; no death and Q-wave MI were observed; reference vessel diameter and MLD for the main branch were 2.79 +/- 0.51 and 1.99 +/- 0.65 mm respectively and for the side branch 2.28 +/- 0.40 and 1.63 +/- 0.48 mm respectively. Restenosis rate in the main branch was 12.2% while in the side branch was 2.0%. CONCLUSIONS: In-hospital outcome indicates that the mini-crush technique for bifurcation lesions with DES can be easily performed. It provides very low total MACE rate and restenosis at 8-month follow-up. These results confirmed the advantage of this specific technique to give complete coverage of the ostium of the side branch using two stents technique. SN - 1522-1946 UR - https://www.unboundmedicine.com/medline/citation/17295334/Long_term_outcomes_of_bifurcation_lesions_after_implantation_of_drug_eluting_stents_with_the_"mini_crush_technique"_ L2 - https://doi.org/10.1002/ccd.21047 DB - PRIME DP - Unbound Medicine ER -