title: Clinical Outcome of Double Kissing Crush Versus Provisional Stenting of Coronary Artery Bifurcation Lesions: The 5-Year Follow-Up Results From a Randomized and Multicenter DKCRUSH-II Study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions).
abstract: Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush stenting reduces the 1-year rate of target lesion revascularization. This study aimed to investigate the 5-year clinical results of the DKCRUSH-II study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions).
  
  
  
  A total of 370 patients with coronary bifurcation lesions who were randomly assigned to either the double kissing crush or provisional stenting group in the DKCRUSH-II study were followed for 5 years. The primary end point was the occurrence of a major adverse cardiac event at 5 years. Patients were classified by simple and complex bifurcation lesions according to the DEFINITION criteria (Definitions and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents). At 5 years, the major adverse cardiac event rate (23.8%) in the provisional stenting group was insignificantly different to that of the double kissing group (15.7%; P=0.051). However, the difference in the target lesion revascularization rate between 2 groups was sustained through the 5-year follow-up (16.2% versus 8.6%; P=0.027). The definite and probable stent thrombosis rate was 2.7% in each group (P=1.0). Complex bifurcation was associated with a higher rate of target lesion revascularization (21.6%) at 5 years compared with 11.1% in patients with a simple bifurcation (P=0.037), with an extremely high rate in the provisional stenting group (36.8% versus 12.5%, P=0.005) mainly because of final kissing balloon inflation (19.4% versus 5.2%; P=0.036).
  
  
  
  The double kissing crush stenting technique for coronary bifurcation lesions is associated with a lower rate of target lesion revascularization. The optimal stenting approach based on the lesions' complexity may improve the revascularization for patients with complex bifurcations.
  
  
  
  URL: http://www.chictr.org. Unique identifier: ChiCTR-TRC-0000015.
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.). chmengx@126.com.
authors.forename: Shao-Liang
authors.initials: SL
authors.lastname: Chen
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Teguh
authors.initials: T
authors.lastname: Santoso
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Zhang
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Fei
authors.initials: F
authors.lastname: Ye
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Xu
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Jing
authors.initials: J
authors.lastname: Kan
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Feng-Fu
authors.initials: FF
authors.lastname: Zhang
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Du-Jiang
authors.initials: DJ
authors.lastname: Xie
authors.affiliation: From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
authors.forename: Tak W
authors.initials: TW
authors.lastname: Kwan
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: angiography; aspirin; coronary artery bifurcation lesions; double kissing crush; myocardial infarction; stents; thrombosis