Double kissing culotte or mini-crush stenting for true coronary bifurcation lesions: the multicenter COLLECT-BIF registry.

This multicenter observational study aimed to retrospectively evaluate the mid-term clinical outcomes of the mini-crush technique (MCT) and double kissing culotte technique (DKCT) in patients with coronary bifurcation lesions (CBLs). This large-scale, multicenter study (n = 8) included patients with CBLs who underwent percutaneous coronary intervention with either MCT or DKCT. The primary endpoint was defined as major adverse cardiac events (MACE), which include cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. A total of 728 patients [male: 584 (80.2%), mean age: 60.93 ± 10.46 years] were included. The initial revascularization strategy was MCT in 476 (65.4%) cases and DKCT in 252 (34.6%) cases. The number of balloons used (6.30 ± 1.84 vs. 5.43 ± 1.99, P < 0.001) and procedure time (65.10 ± 20.34 vs. 61.30 ± 18.48 min, P = 0.020) were significantly higher in the DKCT group. In multivariate Cox regression analysis, risk-adjusted mid-term MACE [hazard ratio (HR): 0.645, (95% confidence interval: 0.395-1.053), P = 0.079] did not differ in the MCT group compared to the DKCT group. Additionally, chronic kidney disease (HR = 2.434, P < 0.001), high SYNTAX score (HR = 1.085, P < 0.001), final kissing balloon inflation (HR = 0.110, P < 0.001), presence of nonfatal intraprocedural complications (HR = 5.818, P < 0.001), and high total cholesterol level (HR = 1.007, P = 0.005) were found to be independent predictors of MACE. This multicenter registry demonstrates that in patients with CBLs, the risk-adjusted MACE rate was similar between both techniques, with a nonsignificant trend favoring MCT at mid-term follow-up.