title: Complex coronary bifurcation revascularization by means of very minimal crushing and ultrathin biodegradable polymer DES: Feasibility and 1-year outcomes of the "Nano-crush" technique.
abstract: OBJECTIVE
  To assess feasibility and 1-year outcomes of ultrathin biodegradable polymer double stenting using a very minimal crushing (nano-crush technique) in a series of patients with large (≥2.5mm) complex coronary bifurcation.
  
  
  METHODS
  From January 2015 to June 2016, patients referred for large (≥2.5mm) complex coronary bifurcation percutaneous coronary interventions (PCI) were enrolled to receive Orsiro (Biotronik Inc., Bulack, Switzerland) double stenting using a very minimal crush technique (nano-crush). Per our institutional protocol, follow-up was conducted by physical examination at 1, 6, 12month and yearly whereas angiographic control was eventually scheduled at 6-8months on the basis of symptoms recurrence or/and positive induced ischemia tests.
  
  
  RESULTS
  Fifty-two patients (15 females mean age 77.2±6.2years) were enrolled. Mean angles between main branch and side branch were 63.6±21.3°. The mean diameter and length of implanted stents were 3.8±0.4mm and 27.1±8.7mm in main branch and 2.8±0.3mm and 22.1±.7.1mm in side branch. Immediate success was 100%. Clinical follow-up was available for 100% of patients: at a mean follow-up of 12.0±2.6months, no patient death, or acute myocardial infarction or target vessel revascularization were observed. Angiographic follow-up was available in 25/52 patients (48%) at a mean time from the procedure of 7.2±0.5months and showed no significant angiographic restenosis.
  
  
  CONCLUSIONS
  The revascularization of complex large (≥2.5mm) coronary bifurcation disease using the nano-crush technique and the ultrathin polymer biodegradable stent appeared feasible in our small study with promising 1year outcomes.
authors: Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy. Electronic address: jackyheart@libero.it.
authors: Gianluca
authors: G
authors: Rigatelli
authors: Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.
authors: Fabio
authors: F
authors: Dell'Avvocata
authors: Department of Internal Medicine, Rovigo General Hospital, Rovigo, Italy.
authors: Marco
authors: M
authors: Zuin
authors: Cardiology Clinic, Alexandroska University Hospital, Sofia, Bulgaria.
authors: Dobrin
authors: D
authors: Vassiliev
authors: Department of Internal Medicine, Rovigo General Hospital, Rovigo, Italy.
authors: Alberto
authors: A
authors: Mazza
authors: Interventional Cardiology Department, Tam Duc Heart Hospital, Ho Chi Minh City, Vietnam.
authors: Huy D
authors: HD
authors: Dinh
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D010865:Pilot Projects; D011108:Polymers / Q000737:chemistry*; D011474:Prosthesis Design; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D011108:Polymers
keywords: Coronary bifurcation; Crush; Interventional; PCI; Stent