3-Year Outcomes of the DKCRUSH-V Trial Comparing DK Crush With Provisional Stenting for Left Main Bifurcation Lesions

Chen, Xiang; Li, Xiaobo; Zhang, Junjie; Han, Yaling; Kan, Jing; Chen, Lianglong; Qiu, Chunguang; Santoso, Teguh; Paiboon, Chootopol; Kwan, Tak; Sheiban, Imad; Leon, Martin B.; Stone, Gregg W.; Chen, Shao‐Liang; Investigators, Dkcrush-V

doi:10.1016/j.jcin.2019.04.056

Cited by 162 publications

(174 citation statements)

References 31 publications

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“…Clinical and bench studies have shown the importance of the POT after FKBI to improve the results [1,[24][25][26]. Although the double kissing (DK) strategy of the DK-crush technique has been reported to be superior to other techniques, the POT has not been applied in the DKCRUSH studies [6,7,27], except for the DKCRUSH-V [19]. In our study, we did not perform the double kissing strategy.…”

Section: Discussionmentioning

confidence: 83%

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An Upfront Two-Stent Strategy for True Coronary Bifurcation Lesions with A Large Side Branch in Acute Coronary Syndrome: A Two-Year Follow-Up Study

Yurtdaş¹,

Asoğlu

Özdemir³

et al. 2020

Medicina

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Background and Objectives: Little is known about the upfront two-stent strategy (U2SS) for true coronary bifurcation lesions (CBLs) in acute coronary syndrome (ACS). We aimed to present our two-year follow-up results on the U2SS by using different two-stent techniques for the true CBL with a large side branch (SB) in ACS patients, including unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI), and to identify independent predictors of the presence of major adverse cardiac events (MACEs) after intervention. Materials and Methods: The study included 201 consecutive ACS patients with true CBLs who underwent percutaneous coronary intervention (PCI) using U2SS from October 2015 to March 2018. Clinical outcomes at follow-up were assessed. MACE was defined as a composite of cardiac death, non-fatal myocardial infarction, and target lesion revascularization (TLR). Results: 31.3% of the patients had an UA, 46.3% had an NSTEMI, and 22.4% had an STEMI. CBL was most frequently located in the left anterior descending (LAD)/diagonal artery (59.2%). In total, 71.1% of the patients had a Medina classification (1,1,1). Overall, 62.2% of cases were treated with mini-crush stenting. Clopidogrel was given in 23.9% of the patients; 71.1% of the patients received everolimus eluting stent (EES); and 11.9% received a sirolimus eluting stent (SES). Final kissing balloon inflation was carried out in all patients, with an unsatisfactory rate of 5%. A proximal optimization technique sequence was successfully carried out in all patients. The MACE incidence was 16.9% with a median follow-up period of 2.1 years. There were seven cardiac deaths (3.5%). The TLR rate was 13.4% (n = 27), with PCI treatment in 16 patients, and coronary artery bypass grafting treatment in 11 patients. After multivariate penalized logistic regression analysis (Firth logistic regression), clopidogrel use (odds ratio (OR): 2.19; 95% confidence interval (CI): 0.41–2.51; p = 0.007) and SES use (OR: 1.86; 95% CI: 0.31–2.64; p = 0.014) were independent predictors of the presence of MACE. Conclusion: U2SS is feasible and safe for the true CBLs with large and diseased SB in ACS patients, and is related to a relatively low incidence of MACE. Clopidogrel use and SES use may predict the MACE development in ACS patients treated using U2SS.

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Section: Discussionmentioning

confidence: 83%

“…However, in the DKCRUSH-II, the 2SS was found to be associated with improved outcomes compared with the PSS [7]. The DKCRUSH-V found that the U2SS resulted in a lower MI, stent thrombosis, and TLR compared with the PSS [19].…”

Section: Discussionmentioning

confidence: 99%

An Upfront Two-Stent Strategy for True Coronary Bifurcation Lesions with A Large Side Branch in Acute Coronary Syndrome: A Two-Year Follow-Up Study

Yurtdaş¹,

Asoğlu

Özdemir³

et al. 2020

Medicina

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“…Approach for Treating Left Main Coronary Bifurcation Lesions (Reproduced with permission) 176 . DK, double kiss [Color figure can be viewed at wileyonlinelibrary.com]…”

Section: Interventional Treatment Of Complex Cadmentioning

confidence: 99%

SCAI position statement on optimal percutaneous coronary interventional therapy for complex coronary artery disease

Riley

Henry

Mahmud

et al. 2020

Cathet Cardio Intervent

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“…There is a consensus that drug-eluting stents should be used, 22 as they reduce complications when compared to bare-metal stent, especially when the implant is performed using IVUS. 34 The DK-CRUSH V study 35 demonstrated better results in one year with the double kissing crush technique when compared with provisional stenting, in terms of treatment failure (5% versus 10.7%, P = 0.02) and risk of stent thrombosis (0.4% versus 3.3%, P = 0.02). These technical details are important and may have an influence on clinical outcomes and should be specifically addressed in upcoming trials.…”

Section: Clinical Trials and Guidelines Recommendationsmentioning

confidence: 99%

Controversies in the Indications of Percutaneous Angioplasty Or Coronary Artery Bypass Grafting In The Treatment Of Left Main Disease

Kalil

́Anna

Salles

2020

International Journal of Cardiovascular Sciences

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3-Year Outcomes of the DKCRUSH-V Trial Comparing DK Crush With Provisional Stenting for Left Main Bifurcation Lesions

Cited by 162 publications

References 31 publications

An Upfront Two-Stent Strategy for True Coronary Bifurcation Lesions with A Large Side Branch in Acute Coronary Syndrome: A Two-Year Follow-Up Study

An Upfront Two-Stent Strategy for True Coronary Bifurcation Lesions with A Large Side Branch in Acute Coronary Syndrome: A Two-Year Follow-Up Study

SCAI position statement on optimal percutaneous coronary interventional therapy for complex coronary artery disease

Controversies in the Indications of Percutaneous Angioplasty Or Coronary Artery Bypass Grafting In The Treatment Of Left Main Disease

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