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MACE lower with double kissing crush than culotte stenting
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SAN FRANCISCO — In a head-to-head comparison, the double kissing crush stent technique was associated with a lower rate of MACE than culotte stenting for patients with unprotected left main coronary artery distal bifurcation lesions, according to results of the DKCRUSH-III trial.
At 1 year, the rate of MACE was 6.2% for patients assigned double kissing (DK) crush stenting (n=210) compared with 16.3% for patients assigned culotte stenting (n=209; P<.05). According to the researchers, the significantly higher rate in the culotte stenting arm was mainly driven by increased target lesion revascularization (6.7%) and target vessel revascularization (10.5%). TLR was 2.4% and TVR was 4.3% in the DK crush arm.
In other results, the rate of in-stent restenosis was higher in the culotte arm (12.64% vs. 6.82%; P=.037), and most common at the ostial side branch. Rate of definite stent thrombosis was 0% in the DK crush arm vs. 1% in the culotte arm (P=.248).
“Although this trial did not include a bypass surgery group to contrast with the stenting techniques, the promising results achieved by DK crush were comparable to those after coronary artery bypass,” Jun-Jie Zhang, MD, interventional cardiologist at Nanjing First Hospital, Nanjing Medical University, China, stated in a press release.
The multicenter DKCRUSH-III study will extend follow-up for participating patients to 5 years, and further research is ongoing. – by Katie Kalvaitis
For more information:
Zhang J. Late-breaking clinical trials II: Interventional. Presented at: American College of Cardiology Scientific Sessions; March 9-11, 2013; San Francisco.
Disclosure: This study was funded by the Jiangsu Provincial Outstanding Medical Program.