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  • Title: Drug-eluting stents for coronary bifurcations: insights into the crush technique.
    Author: Ormiston JA, Currie E, Webster MW, Kay P, Ruygrok PN, Stewart JT, Padgett RC, Panther MJ.
    Journal: Catheter Cardiovasc Interv; 2004 Nov; 63(3):332-6. PubMed ID: 15505853.
    Abstract:
    Sirolimus-eluting stents appear to reduce substantially restenosis following percutaneous coronary bifurcation intervention. The crush technique was devised to reduce restenosis further by improving stent and drug application to the side-branch ostium. We aimed to investigate the performance of drug-eluting stent (DES) platforms with the crush technique, to identify deployment pitfalls, and to clarify the best deployment strategies. Each stage of the crush technique was photographed in a bifurcation phantom. Simultaneous side- and main-branch dilatation (kissing balloons) fully expanded the stent in the side-branch ostium, widened the gaps between stent struts covering the side branch, and eliminated main-branch distortion. With side branches angled at > 70 degrees , sequential (side- then main-branch) inflations may be needed to achieve best results. Postdilatation of the main branch with a balloon of narrower diameter than the deploying balloon caused main-branch stent distortion. These principles applied to all the bifurcation strategies and stent designs tested.
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