Prospective Single‐Center Study of the Nano‐Crush Technique for De Novo True Coronary Bifurcation Lesions

Background Coronary artery disease remains a major global health burden. In complex bifurcation lesions, percutaneous coronary intervention (PCI) is preferred when medical therapy is insufficient. The Nano‐Crush technique, a refined two‐stent approach, offers improved side‐branch ostial coverage with minimal metal overlap and procedural complexity. Aims This single‐center, observational study was conducted to evaluate the procedural outcomes and safety of the Nano‐Crush technique in patients undergoing PCI for de novo coronary bifurcation lesions. Methods Fifty patients with true bifurcation lesions (Medina classification 1.1.1, 0.1.1, or 1.0.1, proximal vessel diameter ≥ 3 mm, and side branch diameter ≥ 2.5 mm) were treated using the Nano‐Crush technique with sirolimus‐eluting stents. The primary endpoint was target vessel failure (TVF) before discharge and at 12 months. Secondary endpoints included procedural success, complication rates, cardiac biomarkers, and safety evaluation. Results The mean age was 63.1 ± 11.5 years, with 90% men. All patients achieved procedural success (final diameter stenosis of < 30% and TIMI Grade 3 flow in both main and side branch vessels) without any periprocedural complications. All patients remained alive and clinically stable at 12 months. Postprocedural troponin increased nonsignificantly ( p = 0.303), while creatine kinase‐myocardial band isoenzyme increased significantly ( p < 0.001). SYNTAX scores declined significantly from a median of 16 (8–23) to 3 (2–6) post‐PCI ( p < 0.001). Four patients experienced mild chest pain at 6 months, managed conservatively. No TVF, target lesion failure, or stent thrombosis occurred at 6 or 12 months. Conclusions The Nano‐Crush technique was associated with encouraging procedural and clinical observations in this selected cohort with true coronary bifurcation lesions. These descriptive findings require validation in larger comparative studies.