Key result
Double Kissing Mini-culotte stenting was associated with a significantly lower 5-year cumulative rate of major adverse cardiovascular events (8.3%) compared to Mini-culotte stenting (22.8%) in patients with true coronary bifurcation lesions.
Why the study?
Clinical outcomes comparing Double Kissing Mini-culotte stenting with Mini-culotte stenting for true coronary bifurcation lesions in the real world remained to be compared.
Does Double Kissing Mini-culotte stenting reduce major adverse cardiovascular events in patients with true coronary bifurcation lesions compared to Mini-culotte stenting?
Cohort (n=180)
No
Does Double Kissing Mini-culotte stenting reduce major adverse cardiovascular events in patients with true coronary bifurcation lesions compared to Mini-culotte stenting?
In patients with true coronary bifurcation lesions, Double Kissing Mini-culotte stenting was associated with a significantly lower 5-year rate of MACE and target vessel/lesion revascularization compared to standard Mini-culotte stenting.
Answers are grounded in this paper and cite their sources.
May support DK mini-culotte for true bifurcation lesions; leaves open randomized confirmation before practice change.
Aims To compare the clinical outcomes between Double Kissing Mini-culotte stenting (DKMC) and Mini-culotte (MC) stenting in treating patients with true coronary bifurcation lesions (CBLs) in the clinical real world. Methods This retrospective observational cohort study included 180 consecutive patients with true CBLs (Medina type 1,1,1; 1,0,1; 0,1,1). All the eligible patients underwent coronary angiography and percutaneous coronary intervention (PCI) with two-stent techniques in our hospital, among whom 97 received DKMC treatment (DKMC group) and 83 MC treatment. The primary clinical endpoints were the major adverse cardiovascular events (MACE), which included cardiac death, myocardial infarction, and target vessel/ lesion revascularization (TVR/TLR). The secondary endpoints were stent thrombosis, in-stent restenosis, and individual components of MACE. Results Quantitative coronary angiography analysis (at 1 year) showed that late lumen loss (0.12 ± 0.42mm vs. 0.22 ± 0.39mm, P = 0.045), segmental diameter restenosis of side branch (17.56 ± 10.23% vs. 23.62 ± 13.28%, P = 0.032) in the DKMC stenting group were lower as compared with MC group. There were similar rates of binary restenosis in the main parent vessel (1.2% vs. 2.9%) and the main branch (4.8% vs. 5.9% in both groups with a numerically lower rate of binary restenosis in the side branch in DKMC (6.2% vs. 13.2%, P = 0.141) irrespective of lack of significant differences. However, compared to MC stenting group, the cumulative event rate of MACE at 5 years (22.8% vs.8.3%, P = 0.007) and TVR/TLR (17.7% vs.6.3%, P = 0.018) in the DKMC stenting group was mainly caused by TVR/TLR. Especially, DKMC was related to a significant reduction in the primary and secondary endpoints in patients with high risk. Conclusion DKMC stenting is associated with lower late lumen loss and restenosis in the side branch, a lower rate of cumulative MACE, and TVR/TLR, and is more effective in treating true CBLs compared to MC stenting; yet, this needs to be further confirmed by a randomized clinical trial.
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Tu et al. (2022) conducted a cohort in True coronary bifurcation lesions (n=180). Double Kissing Mini-culotte stenting (DKMC) vs. Mini-culotte stenting (MC) was evaluated on Major adverse cardiovascular events (MACE) at 5 years (p=0.007). Double Kissing Mini-culotte stenting was associated with a significantly lower 5-year cumulative rate of major adverse cardiovascular events (8.3%) compared to Mini-culotte stenting (22.8%) in patients with true coronary bifurcation lesions.
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