title: DK mini-culotte stenting in the treatment of true coronary bifurcation lesions: a propensity score matching comparison with T-provisional stenting.
abstract: The conventional culotte technique remains not to be widely used for the treatment of coronary bifurcation lesions due to its inherent drawbacks. Here, we developed a double kissing mini-culotte stenting (DK mini-culotte) and assessed its efficacy and safety by a propensity score matching comparison (PSM) with T-provisional stenting. From June 2010 to June 2012, a total of 223 consecutive patients with true coronary bifurcation lesions (TCBLs) were treated with DK mini-culotte (91 patients with 92 lesions) or T-provisional stenting (132 patients with 135 lesions). We performed a PSM to correct the confounders from clinical and lesion's characteristics. The primary endpoint was cumulative major adverse cardiac event (MACE) at 1 year including cardiac death, myocardial infarction, and target vessel revascularization or target lesion revascularization (TVR/TLR). The secondary endpoint was the rate of side branch (SB) restenosis at 12 months. After a PSM, there were 66 patients in each group. Additional SB stenting in the T-provisional group was performed in 10 (15.2 %) lesions. The incidence of 1-year cumulative MACE was 4.55 % for the DK mini-culotte versus 13.6 % for T-provisional stenting (P = 0.127), the rate of TVR/TLR was 1.52 % for DK mini-culotte versus 12.12 % for T-provisional stenting (P = 0.033). The SB binary restenosis rate was 5.6 % in the DK mini-culotte group and 22.4 % in the T-provisional group (P = 0.014). In summary, despite that there is no difference in MACE between groups, DK mini-culotte significantly reduce TVR/TLR and SB restenosis in the treatment of true coronary bifurcation lesions.
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China. rickfan7587@hotmail.com.|Institute of Coronary Heart Disease, Fujian, China. rickfan7587@hotmail.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Fan
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China. lianglongchen@126.com.|Institute of Coronary Heart Disease, Fujian, China. lianglongchen@126.com.|, Xinquan Road 29, Fuzhou, 350001, China. lianglongchen@126.com.
authors.forename: Lianglong
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China.|Institute of Coronary Heart Disease, Fujian, China.
authors.forename: Yukun
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China.|Institute of Coronary Heart Disease, Fujian, China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China.|Institute of Coronary Heart Disease, Fujian, China.
authors.forename: Wenliang
authors.initials: W
authors.lastname: Zhong
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China.|Institute of Coronary Heart Disease, Fujian, China.
authors.forename: Chaogui
authors.initials: C
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China.|Institute of Coronary Heart Disease, Fujian, China.
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China.|Institute of Coronary Heart Disease, Fujian, China.
authors.forename: Yafei
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China.|Institute of Coronary Heart Disease, Fujian, China.
authors.forename: Xingchun
authors.initials: X
authors.lastname: Zhen
authors.affiliation: Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China.|Institute of Coronary Heart Disease, Fujian, China.
authors.forename: Xianfeng
authors.initials: X
authors.lastname: Dong
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D057216:Propensity Score; D011446:Prospective Studies; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: Coronary bifurcation lesions; DK mini-culotte; Percutaneous coronary intervention; T-provisional stenting