Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the "mini-crush technique"

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

Research output: Contribution to journalArticle

59 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)976-983
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume69
Issue number7
DOIs
Publication statusPublished - Jun 1 2007

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Drug-Eluting Stents
Stents
Thrombosis

Keywords

  • Bifurcation lesions
  • DES
  • Mini-crush
  • Stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

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, 69(7), 976-983. https://doi.org/10.1002/ccd.21047

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 P.; Tamburino, Corrado.

In: Catheterization and Cardiovascular Interventions, Vol. 69, No. 7, 01.06.2007, p. 976-983.

Research output: Contribution to journalArticle

Galassi, AR, Colombo, A, Buchbinder, M, Grasso, C, Tomasello, SD, Ussia, GP & Tamburino, C 2007, 'Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the "mini-crush technique"', Catheterization and Cardiovascular Interventions, vol. 69, no. 7, pp. 976-983. https://doi.org/10.1002/ccd.21047
Galassi, Alfredo R. ; Colombo, Antonio ; Buchbinder, Maurice ; Grasso, Carmelo ; Tomasello, Salvatore D. ; Ussia, Gian P. ; Tamburino, Corrado. / Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the "mini-crush technique". In: Catheterization and Cardiovascular Interventions. 2007 ; Vol. 69, No. 7. pp. 976-983.
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AU - Buchbinder, Maurice

AU - Grasso, Carmelo

AU - Tomasello, Salvatore D.

AU - Ussia, Gian P.

AU - Tamburino, Corrado

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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.

AB - 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.

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