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  • Title: 3-year follow-up of 100 consecutive coronary bifurcation lesions treated with Taxus stents and the crush technique.
    Author: Chue CD, Routledge HC, Ludman PF, Townend JN, Epstein AC, Buller NP, Doshi SN.
    Journal: Catheter Cardiovasc Interv; 2010 Mar 01; 75(4):605-13. PubMed ID: 20066725.
    Abstract:
    OBJECTIVES: To determine the 3 year safety and efficacy of crush-stenting with paclitaxel-eluting stents. BACKGROUND: The optimum two-stent strategy for treatment of coronary bifurcation lesions is undetermined. Crush-stenting is advocated to minimize restenosis through complete circumferential stent coverage; long-term follow-up data are lacking. METHODS AND RESULTS: In a single center prospective registry, 100 consecutive patients with bifurcation lesions were treated with the Crush technique. The vast majority (93%) were true bifurcations, predominantly involving the left anterior descending and diagonal arteries. Technical success was 98%. Final kissing balloon dilatation, which became standard practice during the study, was attempted in 68 patients and successful in 51. Abciximab was used in all cases. There were no peri-procedural stent thromboses. Follow-up was 100% at 3 years. Symptom-driven target lesion revascularisation was 8% at 3 years. Cumulative 3-year major adverse cardiac events was 28% (7 cardiac deaths, 15 myocardial infarctions, 11 target vessel revascularisations). Absence of a final kissing inflation predicted repeat revascularisation but not death, infarction or stent thrombosis. Three probable stent thromboses occurred, of which two were very late. CONCLUSION: Where a two-stent bifurcation strategy is required, Crush-stenting with paclitaxel-eluting stents is safe and effective in the long-term. Failure to perform a final kissing dilatation increases the likelihood of revascularisation but not other adverse events.
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