Clinical Outcomes of Double-Kissing Crush or Double-Kissing Culotte in Nonleft Main Bifurcation Lesions: The ROUTE Trial.

IF 6.1 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-10-24 DOI:10.1161/CIRCINTERVENTIONS.124.014616

Serkan Kahraman, Ahmet Y Cizgici, Ahmet Guner, Omer Tasbulak, Cafer Panc, Arda C Dogan, Ahmet E Ulutas, Ismail Gurbak, Umit Bulut, Yalcin Avci, Ali R Demir, Ahmet A Yalcin, Ali K Kalkan, Mehmet Erturk

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Abstract

Background: Double-kissing (DK) crush and DK culotte are the recommended 2-stent strategies in true coronary bifurcation lesions. However, it is a matter of curiosity about which of the DK crush and DK culotte stenting techniques will have superior results. We aimed to compare the clinical outcomes of DK crush and DK culotte stenting in nonleft main coronary artery bifurcation.

Methods: Consecutive patients who received DK crush or DK culotte technique for de novo true nonleft main coronary artery bifurcation lesion were categorized according to which treatment they received. The primary end point of the study was target lesion failure as a composite end point of target lesion revascularization, target vessel myocardial infarction, and cardiac death. Secondary end points were all-cause death and definite stent thrombosis.

Results: A total of 202 patients were categorized as DK crush (101 patients) or DK culotte (101 patients) techniques. The target lesion failure had occurred frequently in the DK crush (10.9%) compared with the DK culotte (3.0%; P=0.028) that was mainly driven by increased target lesion revascularization (9.9% in the DK crush versus 3.0% in the DK culotte; P=0.045). The number of patients with target vessel myocardial infarction (3.0% in the DK crush versus 2.0% in the DK culotte; P=0.651) and cardiac death (1.0% in the DK crush versus 0.0% in the DK culotte; P=0.315) was higher in the DK crush. There were no differences in terms of definite stent thrombosis and all-cause death between groups.

Conclusions: In the present analysis, DK culotte was associated with lower 1-year target lesion failure rates compared with DK crush in true nonleft main coronary artery bifurcations.

Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04789161.

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非左主干分叉病变的双吻合碾压或双吻合Culotte临床疗效：ROUTE 试验

背景：在真正的冠状动脉分叉病变中，双吻（DK）粉碎和 DK culotte 是推荐的双支架策略。然而，DK 压碎和 DK culotte 支架植入技术哪种效果更好一直是个令人好奇的问题。我们的目的是比较在非左冠状动脉主干分叉处进行 DK 压碎和 DK culotte 支架植入术的临床效果：根据接受哪种治疗方法，对接受 DK crush 或 DK culotte 技术治疗新发真性非左主干冠状动脉分叉病变的连续患者进行分类。研究的主要终点是靶病变失败，即靶病变血运重建、靶血管心肌梗死和心源性死亡的复合终点。次要终点是全因死亡和明确的支架血栓形成：共有 202 例患者被归类为 DK crush（101 例）或 DK culotte（101 例）技术。DK crush（10.9%）与 DK culotte（3.0%；P=0.028）相比，靶病变失败发生率更高，这主要是由于靶病变血管再通增加所致（DK crush 为 9.9%，DK culotte 为 3.0%；P=0.045）。DK crush 的靶血管心肌梗死（DK crush 为 3.0%，DK culotte 为 2.0%；P=0.651）和心源性死亡（DK crush 为 1.0%，DK culotte 为 0.0%；P=0.315）患者人数较多。各组在明确的支架血栓形成和全因死亡方面没有差异：在本分析中，DK culotte与DK crush相比，在真正的非左主干冠状动脉分叉中，DK culotte与较低的1年靶病变失败率相关：URL: https://www.clinicaltrials.gov; Unique identifier：NCT04789161。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Circulation: Cardiovascular Interventions CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

1.80%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Circulation: Cardiovascular Interventions, an American Heart Association journal, focuses on interventional techniques pertaining to coronary artery disease, structural heart disease, and vascular disease, with priority placed on original research and on randomized trials and large registry studies. In addition, pharmacological, diagnostic, and pathophysiological aspects of interventional cardiology are given special attention in this online-only journal.