Study On The Modified Culotte Versus DK Crush Technique For The Treatment Of Coronary Artery Bifurcation Lesions

Objective：To investigate the differences between the modified culotte and the doublekissing crush technique for the treatment of coronary artery bifurcation lesions withdrug-eluting stents.Methods：This was a retrospective case-control study, all patientsgrouped by the initial selection of treatment.From January2008to June2011,ninetyone patients were enrolled into this study(DKS,n=31; MCS,n=60).The primary endpoint was major adverse cardiac events (MACEs) after6months. AT the sametime,we compared the CCS class of angina after6months and angiographic resultsafter9-12months of the two groups.Results：Besides the proportion of LAD-D in theDKS group was more than in the MCS group, there were no significant differencesbetween patients from the MCS and the DKS groups in terms of baseline clinicalcharacteristics,or procedural characteristics.The rates of final kissing balloondilatation success in the MCS group were93.3%(n=56) versus90.3%in the DKSgroup(P=0.924).The remaining four cases(6.7%) in the modified culotte group waschanged to DK Crush technique. The preoperative,postoperative and9-12monthsangiographic were also similar in both groups of patients.The failure rate ofimmediate angiography in side branch was0%in MCS group versus2.6%in DKSgroup(P=0.114);and the main vessels were all100%successful.A total of37patientshad a quantitative coronary assessment after9-12months(MCS,n=24;DKS,n=13).The angiographic end-points of in-stent restenosis of main vessel and/or side branchafter9-12months were found in8.3%versus0%(P=0.532) and16.7%versus23.1%(P=0.678) in the MCS group and the DKS group,respectively. No MACEsoccurred in both of the two groups. The CCS classes of angina after6months wereClass I and II mainly,and there was no significant difference between the same levels of the two groups.Conclusions:Both the modified culotte and the DK Crushbifurcation stenting techniques were associated with similar and excellent clinical andangiographic results.The modified culotte stengting was simple,safe,and the6monthsclinical outcomes were satisfied.