DK-Crush or Mini-Crush Stenting for Complex Left Main Bifurcation Lesions: The Multicenter EVOLUTE-CRUSH LM Registry
Journal of the American Heart Association, cilt.14, sa.12, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 14 Sayı: 12
- Basım Tarihi: 2025
- Doi Numarası: 10.1161/jaha.124.040166
- Dergi Adı: Journal of the American Heart Association
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
- Anahtar Kelimeler: double kissing-crush, left main bifurcation, major adverse cardiac events, mini-crush
- Süleyman Demirel Üniversitesi Adresli: Evet
Özet
BACKGROUND: The comparison of outcomes of mini-crush (MCT) versus double kissing crush (DKC) techniques for complex left main bifurcation (LMB) lesions is still lacking. This investigation aimed to assess the long-term outcomes of patients who underwent MCT or DKC for LMB disease. METHODS: From 2014 to 2024, patients who underwent percutaneous coronary intervention for complex LMB lesions were retrospectively collected. The primary end point was major adverse cardiac events as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization during follow-up. The secondary end point was measured as major adverse cardiovascular and cerebral events including all-cause death, target vessel revascularization, target vessel myocardial infarction, stent thrombosis, and stroke. RESULTS: This large-scale multicenter (n=13) observational study included a total of 531 consecutive patients (men: 405 [76.3%], mean age: 63.16±11.26years) with complex LMB lesions who underwent percutaneous coronary intervention. The initial revascularization strategy was MCT in 313 (59%) patients and DKC in 218 (41%) patients. The number of balloons used (5.91±1.53 versus 6.72±1.70, P<0.001) and procedure time (66.60±24.20 versus 72.97±19.97minutes, P<0.001) were notably lower in the MCT group. In the overall population, the long-term major adverse cardiac events (hazard ratio [HR], 0.704; P=0.169) and major adverse cardiovascular and cerebral events (HR, 0.660; P=0.079) did not differ in individuals with complex LMB lesions treated with MCT and DKC. Other end points were also comparable between the 2 groups. CONCLUSIONS: In complex LMB lesions, risk-adjusted major adverse cardiac events and major adverse cardiovascular and cerebral events rates were comparable between both techniques, with a nonsignificant trend favoring DKC at long-term follow-up. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT06546748.