Key result
DK crush offers advantages over other stenting techniques for complex bifurcations but requires careful optimization.
Why the study?
Does the double kissing (DK) crush stenting technique improve angiographic and clinical outcomes in patients with complex coronary bifurcation lesions compared to other stenting techniques?
Does the double kissing (DK) crush stenting technique improve angiographic and clinical outcomes in patients with complex coronary bifurcation lesions compared to other stenting techniques?
The DK crush technique, when performed with specific mandatory steps including careful rewiring and proximal optimization, offers advantages for treating complex coronary bifurcation lesions.
May favor DK crush for complex bifurcations with optimized technique; leaves open need for prospective RCTs.
Clinical data have supported the advantages of the double kissing (DK) crush technique, which consists of stenting the side branch (SB), balloon crush, first kissing, stenting the main vessel (MV) and final kissing balloon inflation, for complex coronary bifurcation lesions compared to other stenting techniques. Careful rewiring from the proximal cell of the MV stent to make sure the wire is in the true lumen of the SB stent is key to acquiring optimal angiographic results. Balloon anchoring from the MV, alternative inflation and each kissing inflation using large enough non-compliant balloons at high pressure, and the proximal optimisation technique are mandatory to improve both angiographic and clinical outcomes. Stratification of a given bifurcation lesion is recommended before decision making.
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Zhang et al. (2015) conducted a review in complex coronary bifurcation lesions. double kissing (DK) crush technique vs. other stenting techniques was evaluated. The double kissing (DK) crush technique provides advantages for complex coronary bifurcation lesions compared to other stenting techniques, requiring careful rewiring and proximal optimization.
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