Key result
Double-kissing crush technique linked to ~269% greater one-year MACE-free survival vs provisional stenting.
Why the study?
The efficacy and safety of the double-kissing crush technique compared with provisional stenting in Vietnamese patients with coronary bifurcation lesions were underexplored, especially in resource-limited settings.
Does the double-kissing crush technique reduce major adverse cardiovascular events compared with provisional stenting in patients with coronary bifurcation lesions?
Cohort (n=58)
Does the double-kissing crush technique reduce major adverse cardiovascular events compared with provisional stenting in patients with coronary bifurcation lesions?
Hazard Ratio: 3.689 (95% CI 1.034–13.16)
Absolute Event Rate: 91% vs 72%
p-value: p=0.03
The double-kissing crush technique significantly reduces major adverse cardiovascular events compared to provisional stenting in patients with coronary bifurcation lesions, despite longer procedural times and higher radiation exposure.
DK crush associated with higher MACE-free survival in bifurcation lesions; leaves open superiority pending randomized trials.
Background Coronary bifurcation lesions (CBLs) present significant challenges in interventional cardiology, especially in low and middle-income countries like Vietnam. While the double-kissing (DK) crush technique is gaining attention for its potential benefits, its efficacy and safety compared with provisional stenting (PS) in the Vietnamese population remain underexplored. This study aimed to assess the effectiveness of the DK crush technique in reducing major adverse cardiovascular events (MACE) compared with those of PS, providing essential data to inform clinical decision-making in settings with limited resources. Methods This prospective cohort study included 58 patients with CBL, 33 patients undergoing the DK crush technique and 25 receiving PS. Clinical follow-up at 1, 3, 9, and 12 months assessed MACE, including cardiovascular disease–related death, acute myocardial infarction, hospitalization for heart failure, and stroke. Results Post-percutaneous coronary intervention side branch diameter stenosis in the DK crush group was 5.64% ± 5.80%, significantly lower than the PS group (48.2% ± 28.5%; P < .001). One-year follow-up data revealed greater MACE reduction in the DK crush group (91% MACE-free vs 72% in the PS group; P = .03; hazard ratio [HR], 3.689; 95% CI, 1.034-13.160). However, the DK crush technique had longer procedural times (91.1 vs 54.6 minutes) and required higher contrast and radiation doses ( P < .01). Conclusions Although DK crush requires longer procedure times and greater radiation exposure, it results in greater MACE reduction than does PS in patients with CBL. Clinicians should weigh the benefits and limitations of both techniques, particularly in resource-limited settings.
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Luong et al. (2025) conducted a cohort in Coronary bifurcation lesions (n=58). Double-kissing crush technique vs. Provisional stenting was evaluated on MACE-free survival (HR 3.689, 95% CI 1.034-13.160, p=0.03). The double-kissing crush technique resulted in a higher 1-year MACE-free rate compared with provisional stenting (91% vs 72%; HR 3.689; 95% CI 1.034-13.160; P=0.03).
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