Bifurcation Lesions: When Two Stents Are Needed, What Is the Best Technique?

In a randomized trial, the crush and culotte techniques produced similarly good results in patients undergoing planned two-stent procedures.

For patients with coronary artery bifurcation lesions, study findings have demonstrated some advantages of a provisional side-branch stenting strategy over planned stenting of both the main vessel and the side branch (JW Cardiol Nov 29 2006). However, even with a provisional strategy, stenting both branches is still necessary in up to one third of patients (JW Cardiol Jan 28 2009). In a randomized study, researchers compared two commonly used techniques, crush and culotte, in 424 patients with bifurcation lesions for which stenting of both branches was planned.

Baseline characteristics were similar in the two groups, although a slightly higher percentage of culotte patients than crush patients had significant side-branch stenosis before sten…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI