Crush techniques for percutaneous coronary intervention of bifurcation lesions

Area of Science:

• Interventional Cardiology
• Cardiovascular Medicine
• Medical Device Technology

Background:

• Percutaneous coronary intervention (PCI) for coronary artery bifurcation lesions presents significant technical challenges.
• These complex lesions are associated with a higher risk of adverse events, including repeat revascularization and stent thrombosis.
• While a provisional (single-stent) approach suffices for simpler bifurcations, true bifurcation lesions necessitate a two-stent strategy.

Purpose of the Study:

• To review the evolution of the crush technique for treating coronary artery bifurcation lesions.
• To discuss the technical aspects and clinical outcomes of various crush technique iterations.
• To highlight the efficacy of modern crush techniques for both left main and non-left main bifurcations.

Main Methods:

• Review of historical development and technical modifications of the crush technique.
• Analysis of published data on the outcomes of different crush technique variants.
• Focus on strategies for complex true bifurcation lesions requiring two-stent approaches.

Main Results:

• The crush technique has undergone significant evolution since its inception in the early 2000s.
• Recent iterations of the crush technique demonstrate excellent and durable clinical results.
• These improved outcomes are observed in both left main and non-left main coronary artery bifurcations.

Conclusions:

• The crush technique, especially its contemporary forms, is a valuable strategy for managing complex coronary artery bifurcation lesions.
• Modern crush techniques provide reliable and long-lasting results, mitigating risks associated with bifurcation PCI.
• Continued refinement and application of the crush technique are crucial for optimizing patient care in interventional cardiology.