Evolution of the Crush Technique for Bifurcation Stenting

Bifurcation lesions are frequently encountered, associated with greater procedural complexity and consequently are at higher risk for restenosis and stent thrombosis. Early trials in bifurcation percutaneous coronary intervention favored a provisional stenting approach, but contemporary randomized t...

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Bibliographic Details
Published in:JACC. Cardiovascular interventions 2021-11, Vol.14 (21), p.2315-2326
Main Authors: Raphael, Claire E, O'Kane, Peter D, Johnson, Thomas W, Prasad, Abhiram, Gulati, Rajiv, Sandoval, Yader, Di Mario, Carlo, Holmes, Jr, David R
Format: Article
Language:English
Subjects:
Coronary Angiography - methods
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - therapy
Humans
Percutaneous Coronary Intervention - adverse effects
Percutaneous Coronary Intervention - methods
Stents
Thrombosis
Time Factors
Treatment Outcome
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Summary:Bifurcation lesions are frequently encountered, associated with greater procedural complexity and consequently are at higher risk for restenosis and stent thrombosis. Early trials in bifurcation percutaneous coronary intervention favored a provisional stenting approach, but contemporary randomized trials have highlighted potentially superior outcomes using a double-kiss crush technique in unprotected distal left main stem bifurcation lesions. Although the evidence is greatest for double-kiss crush, many operators favor a mini-crush or nano-crush single-kiss approach. In this review, the authors describe the iterations of the crush technique and the evidence for each and review general principles for bifurcation percutaneous coronary intervention.
ISSN:1936-8798
1876-7605
DOI:10.1016/j.jcin.2021.08.048