title: Crush stenting with drug-eluting stents: relevance of coronary bifurcation lesion location on angiographic and clinical outcomes.
abstract: BACKGROUND
  Data on the relevance of the location of coronary bifurcation lesions treated by crush stenting with outcomes were limited.
  
  
  OBJECTIVE
  We hypothesized that the location of the bifurcation lesion correlated with clinical outcome.
  
  
  METHODS
  A total of 212 patients with 230 true bifurcation lesions treated by crush stenting with drug-eluting stents (DES) were assessed prospectively. Surveillance quantitative angiographies were indexed at 8 months after procedure. Primary endpoint was major adverse cardiac events (MACE), defined as cardiac death, myocardial infarction, and target lesion revascularization (TLR).
  
  
  RESULTS
  Patients in the distal right coronary artery (RCAd) group were characterized by higher proportions of prior myocardial infarction and very tortuous lesions. However, lesions in the RCAd group, compared to those of other groups, had the lowest late lumen loss, with resultant lowest incidence of MACE at a mean follow-up of 268±35 days. Independent predictors of MACE included unsatisfied kissing (KUS; hazard ratio [HR]: 12.14, 95% confidence interval [CI]: 4.01-12.10, P = .001) and non-RCA lesion (HR: 20.69, 95% CI: 5.05-22.38, P = .001), while those of TLR were KUS (HR: 10.21, 95% CI: 0.01-0.34, P = .002), bifurcation angle (HR: 4.728, 95% CI: 2.541-4.109, P = .001), and non-RCA lesion (HR: 16.05, 95%CI: 1.01-4.83, P = .001).
  
  
  CONCLUSIONS
  Classical crush stenting with drug-eluting stents is associated with significantly better outcomes in RCAd. Quality of kissing inflation is mandatory to improve outcome.
authors.affiliation: Nanjing First Hospital, Nanjing Medical University, China. chmengx@126.com
authors.forename: Shao-Liang
authors.initials: SL
authors.lastname: Chen
authors.forename: Jun-jie
authors.initials: JJ
authors.lastname: Zhang
authors.forename: Fei
authors.initials: F
authors.lastname: Ye
authors.forename: Zhi-zhong
authors.initials: ZZ
authors.lastname: Liu
authors.forename: Zhong-sheng
authors.initials: ZS
authors.lastname: Zhu
authors.forename: Song
authors.initials: S
authors.lastname: Lin
authors.forename: Nai-liang
authors.initials: NL
authors.lastname: Tian
authors.forename: Wei-yi
authors.initials: WY
authors.lastname: Fang
authors.forename: Yun-dai
authors.initials: YD
authors.lastname: Chen
authors.forename: Xue-wen
authors.initials: XW
authors.lastname: Sun
authors.forename: Meng
authors.initials: M
authors.lastname: Wei
authors.forename: Shou-jie
authors.initials: SJ
authors.lastname: Shan
authors.forename: Jing
authors.initials: J
authors.lastname: Kan
authors.forename: Jun
authors.initials: J
authors.lastname: Qian
authors.forename: Song
authors.initials: S
authors.lastname: Yang
authors.forename: Zeng-bai
authors.initials: ZB
authors.lastname: Yuan
authors.forename: Tak W
authors.initials: TW
authors.lastname: Kwan
authors.forename: Da-Yi
authors.initials: DY
authors.lastname: Hu
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage; D016009:Chi-Square Distribution; D002681:China; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D017239:Paclitaxel / Q000008:administration & dosage; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020123:Sirolimus / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D017239:Paclitaxel; D020123:Sirolimus