Key result
Modified balloon crush links to similar MACE but lower target lesion revascularization versus conventional crush.
Why the study?
Does the modified balloon crush technique reduce major adverse cardiovascular events compared to the conventional crush technique in patients with coronary bifurcation lesions undergoing PCI?
Observational (n=515)
No
Does the modified balloon crush technique reduce major adverse cardiovascular events compared to the conventional crush technique in patients with coronary bifurcation lesions undergoing PCI?
Absolute Event Rate: 7.3% vs 8.8%
p-value: p=.73
The modified balloon crush technique is a feasible and safe alternative to the conventional crush technique for coronary bifurcation lesions, demonstrating a significant reduction in target lesion revascularization rates.
Should not yet change bifurcation PCI practice; leaves open randomized confirmation of reduced revascularization.
This study aimed to investigate the feasibility and safety of the modified balloon crush technique.The conventional crush technique accompanies difficult and suboptimal final kissing balloon inflation (FKI)In a single-center percutaneous coronary intervention registry, 515 patients with 515 bifurcation lesions were treated with the modified balloon technique (n = 70) or the conventional crush technique (n = 445). In contrast to the conventional crush technique, where the implanted side branch (SB) stent is crushed by expansion of the main branch (MB) stent, the modified balloon crush technique uses balloon crushing and additional SB ballooning across the crushed SB stent before MB stenting to facilitate FKI. The primary outcome of interest was major adverse cardiovascular event (MACE), a composite of all-cause death, spontaneous myocardial infarction, and target vessel revascularization.Baseline clinical and angiographic characteristics were similar between the 2 treatment groups. FKI had comparable success rates in both groups (97.1% for the modified balloon group and 98.4% for the conventional crush group; P = .35). There were no differences in procedure time, fluoroscopic time, or contrast amount between the 2 groups. At 1-year follow up, the cumulative MACE incidences were comparable between the 2 groups (7.3% vs 8.8%; P = .73). The incidence of target lesion revascularization (TLR) was significantly lower after the modified balloon crush technique compared with the conventional crush technique (0% vs 5.6%; P = .048).The modified balloon crush technique appears to be a feasible and safe alternative to the conventional crush technique with the potential to reduce the revascularization rate.
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Roh et al. (2018) conducted an observational in Coronary bifurcation lesions (n=515). Modified balloon crush technique vs. Conventional crush technique was evaluated on Major adverse cardiovascular event (MACE), a composite of all-cause death, spontaneous myocardial infarction, and target vessel revascularization (p=.73). The modified balloon crush technique resulted in a comparable 1-year incidence of major adverse cardiovascular events (7.3% vs 8.8%) and significantly lower target lesion revascularization (0% vs 5.6%) compared to the conventional crush technique.
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