There have been growing efforts to identify the ideal method of percutaneous coronary intervention (PCI) in coronary bifurcation lesions due to the complexity of the procedure and the variable degree of optimal results [ ]. Although provisional stenting is considered the first- line treatment of coronary bifurcation lesions, this statement lacks accuracy without specifying the type of the bifurcation lesions [ ]. Chen et al. in the DKCRUSH II trial used the Medina classification to guide the treatment decision comparing the double-kissing (DK) crush vs provisional intervention in non-left main lesions, and the DK crush technique was superior in terms of target lesion revascularization at 12 months for lesions classified as (1,1,1 or 0,1,1) [ ]. Similarly, the DK crush technique was superior to provisional stenting for distal left main bifurcation lesions in the DKCRUSH V trial [ ] . More specified criteria were used to further guide the decision in the DEFINITION II trial, so they included the side-branch diameter, the length of the side-branch lesion, the severity of stenosis, the bifurcation angle, and the Medina classification. For such complex lesions, the two-stent strategies, DK crush or Culotte, were superior in comparison with provisional stenting [ ].
Cardiovascular Revascularization Medicine Volume 24, March 2021, Pages 18-19
Read the full article on Science Direct: Modeling the Ideal 2-Stent Strategy in Coronary Bifurcation! Is There Light at the End of the Tunnel?