Percutaneous Treatment of Bifurcation Lesions by Crush T Stenting: Immediate and Medium- Term Outcomes

Introduction and objectives Percutaneous coronary intervention for coronary bifurcations is usually associated with a low success rate, a high rate of complications, and a more frequent need for target lesion revascularization. The aim of this prospective study was to evaluate immediate and medium-term clinical and angiographic outcomes after the application of crush T stenting. Methods This approach to bifurcation stenting follows the same steps as modified T stenting. The only difference is that the side branch stent protrudes 3–4 mm into the main vessel from the carina. The aim is to ensure that the circumference of the side branch ostium is covered by the stent strut. Results Between December 2003 and February 2005, 82 patients were included in the study. The lesion involved the left main coronary artery in 53% of patients, the left anterior descending or diagonal coronary artery in 29%, the circumflex or marginal branch in 11%, and the right coronary artery or the posterior or posterolateral descending branch in 7%. Angiographic and clinical success was obtained in 100% and 96.4% of cases, respectively. Final dilatation was performed using a kissing balloon in 87%. Overall, 100% of patients were followed up clinically for 12 months and 77% were followed up angiographically for a mean of 8.7 (3.3) months. Target lesion revascularization was performed in 9 patients (10.8%). Conclusions Treatment of coronary bifurcation lesions using the crush T stenting technique is safe and effective. It reduces both the restenosis rate and the major adverse cardiac event rate at one year.