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Bifurcation lesions.

Antonio Colombo1

  • 1EMO Centro Cuore Columbus, and Interventional Cardiology Unit, San Raffaele Hospital, Milan, Italy. info@emocolumbus.it

Italian Heart Journal : Official Journal of the Italian Federation of Cardiology
|July 13, 2005
PubMed
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Drug-eluting stents improve coronary bifurcation lesion treatment. The "Crush" or "V" techniques with two stents show good results, especially with final kissing balloon inflation for side branch restenosis.

Area of Science:

  • Interventional Cardiology
  • Biomedical Engineering
  • Vascular Surgery

Background:

  • Drug-eluting stents (DES) have enhanced outcomes for coronary bifurcation lesions.
  • Optimal stenting strategies for true bifurcations remain debated, particularly two-stent vs. provisional approaches.

Purpose of the Study:

  • To evaluate the effectiveness of the "Crush" or "V" two-stent techniques for coronary bifurcation lesions.
  • To assess the impact of final kissing balloon inflation on restenosis rates.

Main Methods:

  • Retrospective analysis of 70 patients treated with sirolimus-eluting stents using the "Crush" technique.
  • 6-month angiographic follow-up to determine restenosis rates in main and side branches.
  • Comparison of outcomes with and without final kissing balloon inflation.

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Main Results:

  • Overall 6-month restenosis rate was 33% (7% in main/side branches, 26% in side branches).
  • No significant difference in main branch restenosis between groups with and without final kissing balloon inflation (4% vs. 8%).
  • Significantly lower side branch restenosis in the final kissing balloon group (17%) compared to the no final kissing group (42%).

Conclusions:

  • The "Crush" and "V" techniques with DES offer good results for bifurcation lesions.
  • Final kissing balloon inflation is crucial for reducing side branch restenosis.
  • DES, particularly with two-stent strategies, represent a significant advancement over bare metal stents for bifurcation treatment.