Fatih Uzun, Ahmet Güner, Aykun Hakgör, Elnur Alizade, Mehmet B Karataş, Gökhan Alıcı, Ahmet Y Çizgici, İrfan Şahin, İlker Gül, Hamdi Püşüroğlu, Ahmet Karaduman, Cemalettin Akman, Ali E Ataş, Muhammed F Deniz, Deniz N Tekin, Ebru Serin, Mehmet Kocaağa, Mustafa Yaşan, İlhan I Avcı, Oktay Şenöz, Perihan Varım, Abdullah Doğan, Atakan Dursun, Tuba Unkun, İlyas Çetin, Murat Gökalp, Veysel O Tanık, İbrahim F Aktük, Beytullah Çakal, Kudret Keskin, Ezgi G Güner, Aybüke Şimşek, Muhammet A Ekiz, Seda T Üzel, Çağdaş Bulus, Koray Çiloğlu, Muhammed M Göksu, Ali N Çalık, Bilal Boztosun
{"title":"复杂左主干分叉病变的DK-Crush或Mini-Crush支架置入：多中心EVOLUTE-CRUSH LM注册","authors":"Fatih Uzun, Ahmet Güner, Aykun Hakgör, Elnur Alizade, Mehmet B Karataş, Gökhan Alıcı, Ahmet Y Çizgici, İrfan Şahin, İlker Gül, Hamdi Püşüroğlu, Ahmet Karaduman, Cemalettin Akman, Ali E Ataş, Muhammed F Deniz, Deniz N Tekin, Ebru Serin, Mehmet Kocaağa, Mustafa Yaşan, İlhan I Avcı, Oktay Şenöz, Perihan Varım, Abdullah Doğan, Atakan Dursun, Tuba Unkun, İlyas Çetin, Murat Gökalp, Veysel O Tanık, İbrahim F Aktük, Beytullah Çakal, Kudret Keskin, Ezgi G Güner, Aybüke Şimşek, Muhammet A Ekiz, Seda T Üzel, Çağdaş Bulus, Koray Çiloğlu, Muhammed M Göksu, Ali N Çalık, Bilal Boztosun","doi":"10.1161/JAHA.124.040166","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The comparison of outcomes of mini-crush (MCT) versus double kissing crush (DKC) techniques for complex left main bifurcation (LMB) lesions is still lacking. This investigation aimed to assess the long-term outcomes of patients who underwent MCT or DKC for LMB disease.</p><p><strong>Methods: </strong>From 2014 to 2024, patients who underwent percutaneous coronary intervention for complex LMB lesions were retrospectively collected. The primary end point was major adverse cardiac events as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization during follow-up. The secondary end point was measured as major adverse cardiovascular and cerebral events including all-cause death, target vessel revascularization, target vessel myocardial infarction, stent thrombosis, and stroke.</p><p><strong>Results: </strong>This large-scale multicenter (n=13) observational study included a total of 531 consecutive patients (men: 405 [76.3%], mean age: 63.16±11.26 years) with complex LMB lesions who underwent percutaneous coronary intervention. The initial revascularization strategy was MCT in 313 (59%) patients and DKC in 218 (41%) patients. The number of balloons used (5.91±1.53 versus 6.72±1.70, <i>P</i><0.001) and procedure time (66.60±24.20 versus 72.97±19.97 minutes, <i>P</i><0.001) were notably lower in the MCT group. In the overall population, the long-term major adverse cardiac events (hazard ratio [HR], 0.704; <i>P</i>=0.169) and major adverse cardiovascular and cerebral events (HR, 0.660; <i>P</i>=0.079) did not differ in individuals with complex LMB lesions treated with MCT and DKC. Other end points were also comparable between the 2 groups.</p><p><strong>Conclusions: </strong>In complex LMB lesions, risk-adjusted major adverse cardiac events and major adverse cardiovascular and cerebral events rates were comparable between both techniques, with a nonsignificant trend favoring DKC at long-term follow-up.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique Identifier: NCT06546748.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040166"},"PeriodicalIF":5.0000,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"DK-Crush or Mini-Crush Stenting for Complex Left Main Bifurcation Lesions: The Multicenter EVOLUTE-CRUSH LM Registry.\",\"authors\":\"Fatih Uzun, Ahmet Güner, Aykun Hakgör, Elnur Alizade, Mehmet B Karataş, Gökhan Alıcı, Ahmet Y Çizgici, İrfan Şahin, İlker Gül, Hamdi Püşüroğlu, Ahmet Karaduman, Cemalettin Akman, Ali E Ataş, Muhammed F Deniz, Deniz N Tekin, Ebru Serin, Mehmet Kocaağa, Mustafa Yaşan, İlhan I Avcı, Oktay Şenöz, Perihan Varım, Abdullah Doğan, Atakan Dursun, Tuba Unkun, İlyas Çetin, Murat Gökalp, Veysel O Tanık, İbrahim F Aktük, Beytullah Çakal, Kudret Keskin, Ezgi G Güner, Aybüke Şimşek, Muhammet A Ekiz, Seda T Üzel, Çağdaş Bulus, Koray Çiloğlu, Muhammed M Göksu, Ali N Çalık, Bilal Boztosun\",\"doi\":\"10.1161/JAHA.124.040166\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The comparison of outcomes of mini-crush (MCT) versus double kissing crush (DKC) techniques for complex left main bifurcation (LMB) lesions is still lacking. This investigation aimed to assess the long-term outcomes of patients who underwent MCT or DKC for LMB disease.</p><p><strong>Methods: </strong>From 2014 to 2024, patients who underwent percutaneous coronary intervention for complex LMB lesions were retrospectively collected. The primary end point was major adverse cardiac events as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization during follow-up. The secondary end point was measured as major adverse cardiovascular and cerebral events including all-cause death, target vessel revascularization, target vessel myocardial infarction, stent thrombosis, and stroke.</p><p><strong>Results: </strong>This large-scale multicenter (n=13) observational study included a total of 531 consecutive patients (men: 405 [76.3%], mean age: 63.16±11.26 years) with complex LMB lesions who underwent percutaneous coronary intervention. The initial revascularization strategy was MCT in 313 (59%) patients and DKC in 218 (41%) patients. The number of balloons used (5.91±1.53 versus 6.72±1.70, <i>P</i><0.001) and procedure time (66.60±24.20 versus 72.97±19.97 minutes, <i>P</i><0.001) were notably lower in the MCT group. In the overall population, the long-term major adverse cardiac events (hazard ratio [HR], 0.704; <i>P</i>=0.169) and major adverse cardiovascular and cerebral events (HR, 0.660; <i>P</i>=0.079) did not differ in individuals with complex LMB lesions treated with MCT and DKC. Other end points were also comparable between the 2 groups.</p><p><strong>Conclusions: </strong>In complex LMB lesions, risk-adjusted major adverse cardiac events and major adverse cardiovascular and cerebral events rates were comparable between both techniques, with a nonsignificant trend favoring DKC at long-term follow-up.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique Identifier: NCT06546748.</p>\",\"PeriodicalId\":54370,\"journal\":{\"name\":\"Journal of the American Heart Association\",\"volume\":\" \",\"pages\":\"e040166\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-06-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Heart Association\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1161/JAHA.124.040166\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Heart Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/JAHA.124.040166","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/21 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
DK-Crush or Mini-Crush Stenting for Complex Left Main Bifurcation Lesions: The Multicenter EVOLUTE-CRUSH LM Registry.
Background: The comparison of outcomes of mini-crush (MCT) versus double kissing crush (DKC) techniques for complex left main bifurcation (LMB) lesions is still lacking. This investigation aimed to assess the long-term outcomes of patients who underwent MCT or DKC for LMB disease.
Methods: From 2014 to 2024, patients who underwent percutaneous coronary intervention for complex LMB lesions were retrospectively collected. The primary end point was major adverse cardiac events as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization during follow-up. The secondary end point was measured as major adverse cardiovascular and cerebral events including all-cause death, target vessel revascularization, target vessel myocardial infarction, stent thrombosis, and stroke.
Results: This large-scale multicenter (n=13) observational study included a total of 531 consecutive patients (men: 405 [76.3%], mean age: 63.16±11.26 years) with complex LMB lesions who underwent percutaneous coronary intervention. The initial revascularization strategy was MCT in 313 (59%) patients and DKC in 218 (41%) patients. The number of balloons used (5.91±1.53 versus 6.72±1.70, P<0.001) and procedure time (66.60±24.20 versus 72.97±19.97 minutes, P<0.001) were notably lower in the MCT group. In the overall population, the long-term major adverse cardiac events (hazard ratio [HR], 0.704; P=0.169) and major adverse cardiovascular and cerebral events (HR, 0.660; P=0.079) did not differ in individuals with complex LMB lesions treated with MCT and DKC. Other end points were also comparable between the 2 groups.
Conclusions: In complex LMB lesions, risk-adjusted major adverse cardiac events and major adverse cardiovascular and cerebral events rates were comparable between both techniques, with a nonsignificant trend favoring DKC at long-term follow-up.
期刊介绍：
As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice.
JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.
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