Author + information
- Received January 13, 2005
- Accepted March 10, 2005
- Published online August 16, 2005.
- Lei Ge, MD⁎,†,
- Flavio Airoldi, MD⁎,
- Ioannis Iakovou, MD⁎,
- John Cosgrave, MD⁎,
- Iassen Michev, MD⁎,
- Giuseppe M. Sangiorgi, MD⁎,
- Matteo Montorfano, MD⁎,
- Alaide Chieffo, MD⁎,
- Mauro Carlino, MD⁎,
- Nicola Corvaja, MD⁎ and
- Antonio Colombo, MD, FACC⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Antonio Colombo, EMO Centro Cuore Columbus, 48 Via M. Buonarroti, 20145 Milan, Italy.
Objectives The purpose of this research was to evaluate the long-term outcomes after implantation of drug-eluting stents (DES) in bifurcation lesions with the “crush” technique.
Background The long-term outcome of “crush” stenting technique has yet to be determined.
Methods We identified 181 consecutive patients who were treated with DES with the “crush” stent technique from April 2002 to April 2004. Based on the usage of final kissing balloon post-dilation (FKB), the patients were divided into an FKB group (n = 116) and a non-FKB group (n = 65).
Results Clinical follow-up at nine months was available in all patients, and angiographic follow-up in 80% of patients. Three cases (1.7%) of intraprocedural stent thrombosis and five (2.8%) cases of postprocedural stent thrombosis occurred. Restenosis rate of the main branch in the entire cohort lesions was 11.5%. Restenosis rate of the side branch was lower in the FKB group than that in the non-FKB group (11.1% vs. 37.9%, p < 0.001). The target lesion revascularization (TLR) rate for all patients was 14.9%. The lack of FKB was a predictor for TLR (hazard ratio [HR] 4.17; 95% confidence interval [CI] 1.30 to 14.3, p = 0.02). Diabetes was also a predictor for TLR (HR 1.79; 95% CI 1.14 to 2.80, p = 0.01). Premature discontinuation of dual antiplatelet therapy (odds ratio [OR] 16.8; 95% CI 1.31 to 159.5, p = 0.03) and age (OR 1.10; 95% CI 1.00 to 1.21, p = 0.048) was associated with the occurrence of postprocedural stent thrombosis.
Conclusions Compared to the absence of FKB, the “crush” stenting technique with FKB appears to be associated with more favorable long-term outcomes. When utilizing the “crush” stenting technique, FKB is mandatory.
The first two authors contributed equally to this work.
- Received January 13, 2005.
- Accepted March 10, 2005.
- American College of Cardiology Foundation