title: Randomized Comparison of the Crush Versus the Culotte Stenting for Coronary Artery Bifurcation Lesions.
abstract: BACKGROUND
  The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment. However, their comparative performance remains elusive.
  
  
  METHODS
  A total of 300 patients with coronary bifurcation lesions were randomly assigned to crush (n = 150) and culotte (n = 150) treatment. The primary endpoint was the occurrence of major adverse cardiac events (MACEs) at 12 months including cardiac death, myocardial infarction, stent thrombosis, and target vessel revascularization. Index lesion restenosis at 12 months was a secondary endpoint. The surface integrals of time-averaged wall shear stress at bifurcation sites were also be quantified.
  
  
  RESULTS
  There were no significant differences in MACE rates between the two groups at 12-month follow-up: Crush 6.7%, culotte 5.3% (P = 0.48). The rates of index lesion restenosis were 12.7% versus 6.0% (P = 0.047) in the crush and the culotte groups, respectively. At 12-month follow-up, the surface integrals of time-averaged wall shear stress at bifurcation sites in the crush group were significantly lower than the culotte group ([5.01 ± 0.95] × 10-4 Newton and [6.08 ± 1.16] × 10-4 Newton, respectively; P = 0.003).
  
  
  CONCLUSIONS
  Both the crush and the culotte bifurcation stenting techniques showed satisfying clinical and angiographic results at 12-month follow-up. Bifurcation lesions treated with the culotte technique tended to have lower restenosis rates and more favorable flow patterns.
authors.forename: Xu-Wei
authors.initials: XW
authors.lastname: Zheng
authors.forename: Dong-Hui
authors.initials: DH
authors.lastname: Zhao
authors.forename: Hong-Yu
authors.initials: HY
authors.lastname: Peng
authors.forename: Qian
authors.initials: Q
authors.lastname: Fan
authors.forename: Qin
authors.initials: Q
authors.lastname: Ma
authors.forename: Zhen-Ye
authors.initials: ZY
authors.lastname: Xu
authors.forename: Chao
authors.initials: C
authors.lastname: Fan
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
authors.forename: Jing-Hua
authors.initials: JH
authors.lastname: Liu
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D015607:Stents