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Double kissing culotte or mini-crush stenting for true coronary bifurcation lesions: the multicenter COLLECT-BIF

Ahmet Yaşar Çizgici1, Aybüke Şimşek1, Hande Uysal1

  • 1Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital.

Coronary Artery Disease
|August 12, 2025
PubMed

Insights

The mini-crush technique (MCT) and double kissing culotte technique (DKCT) showed similar mid-term clinical outcomes for coronary bifurcation lesions (CBLs). While not statistically significant, the mini-crush technique trended towards better results in this large observational study.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Research
  • Medical Technology Evaluation

Background:

  • Coronary bifurcation lesions (CBLs) pose complex challenges in percutaneous coronary intervention.
  • The mini-crush technique (MCT) and double kissing culotte technique (DKCT) are two strategies for addressing CBLs.
  • Evaluating the comparative mid-term clinical efficacy of these techniques is crucial for optimizing patient care.

Purpose of the Study:

  • To retrospectively compare the mid-term clinical outcomes of MCT versus DKCT in patients with CBLs.
  • To assess the incidence of major adverse cardiac events (MACE) between the two techniques.
  • To identify predictors of MACE in patients undergoing percutaneous coronary intervention for CBLs.

Main Methods:

  • A multicenter, observational study involving 728 patients with CBLs.
  • Patients were treated with either MCT (n=476) or DKCT (n=252).
  • Primary endpoint was MACE (cardiac death, target vessel MI, or target lesion revascularization).

Main Results:

  • No significant difference in risk-adjusted mid-term MACE between MCT and DKCT (HR 0.645, P=0.079).
  • DKCT group had significantly higher balloon usage and procedure time.
  • Independent predictors of MACE included chronic kidney disease, high SYNTAX score, nonfatal intraprocedural complications, and high total cholesterol.

Conclusions:

  • MCT and DKCT demonstrate comparable risk-adjusted mid-term MACE rates in patients with CBLs.
  • A nonsignificant trend favored MCT regarding MACE at mid-term follow-up.
  • Final kissing balloon inflation was associated with reduced MACE risk.
Abstract

Keywords:
coronary bifurcation lesiondouble kissing culottemini-crushmyocardial infarctiontarget vessel revascularization

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