title: A prospective registry to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions using the "crush technique".
abstract: The "crush technique" has been proposed as an alternative approach to treat bifurcation lesions because of its predictability and high procedural success rate. However, few data are available regarding its safety and long-term efficacy. We report the long-term clinical outcomes of patients with coronary bifurcation lesions treated with sirolimus-eluting stents using the crush technique. From April 2003 to May 2004, 120 patients with coronary bifurcation lesions were treated with sirolimus-eluting stents using the crush technique. Six months of clinical follow-up was completed in 95.8% of patients. Mean patient age was 64 years; 36% had diabetes mellitus, and the left anterior descending artery/diagonal was the most frequent bifurcation location (69%). Final kissing balloon inflation was performed in 87.5% of patients. Compared with the main vessel, side branch lesions were shorter, with a smaller reference diameter and final in-stent minimum lumen diameter. Procedural success was achieved in 97.5%. At 30 days of follow-up, 1 patient had died of noncardiac causes and 2 patients (1.7%) had subacute stent thrombosis. At 6 months of follow-up, target lesion revascularization was required in 13 patients (11.3%), all of whom had focal restenosis predominantly at the side branch ostium. In conclusion, the crush technique with final kissing balloon inflation can be safely used by experienced operators to treat highly complex bifurcation lesions with sirolimus-eluting stents. The safety profile of this technique is similar to that of other bifurcation stenting techniques reported thus far. Nonetheless, despite the excellent patency rates of the main vessel, the need for revascularization at the ostium of the side branch was not fully eliminated.
authors.affiliation: Cardiovascular Research Foundation and New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA. imoussa@crf.org
authors.forename: Issam
authors.initials: I
authors.lastname: Moussa
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Costa
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Lansky
authors.forename: Zoran
authors.initials: Z
authors.lastname: Lasic
authors.forename: Ecaterina
authors.initials: E
authors.lastname: Cristea
authors.forename: Nenad
authors.initials: N
authors.lastname: Trubelja
authors.forename: Stephane G
authors.initials: SG
authors.lastname: Carlier
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
authors.forename: Giora
authors.initials: G
authors.lastname: Weisz
authors.forename: Edward M
authors.initials: EM
authors.lastname: Kreps
authors.forename: Michael
authors.initials: M
authors.lastname: Collins
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D023903:Coronary Restenosis / Q000628:therapy; D023921:Coronary Stenosis / Q000628:therapy*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D019233:Retreatment; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus