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Comparison of Long-term Clinical Outcomes Between Classic “Crush” and “Modified Mini-crush” technique in Coronary Bifurcation Lesions

Yang, Hyoung-Mo; Tahk, Seung-Jea; Choi, So-Yeon; Yoon, Myeong-Ho; Lim, Hong-Seok; Choi, Byung-Joo; Seo, Kyoung-Woo; Kim, Jin-Woo; Hwang, Gyo-Seung; Jin, Xiong Jie
Department of Cardiology, Ajou University School of Medicine
OBJECTIVES: We aimed to compare long-term clinical outcomes between modified mini-crush (modi-MC) technique with classic crush (Crush) technique for treatment of bifurcation lesions.
BACKGROUND: The Modi-MC technique showed excellent procedural success and favorable 9-month clinical outcomes. Methods: From Jan 2005 to Nov 2009, we enrolled patients with de novo bifurcation lesions treated with modi-MC (n=112 lesions in 111 patients) and Crush technique (n=69 lesions in 67 patients). Primary endpoint was rate of major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction (MI), and target lesion revascularization (TLR) at 3 years.
RESULTS: There was no significant difference in baseline characteristics. The modi-MC technique showed a significantly higher success rate of final kissing balloon inflation (84.1% vs. 98.2%, p=0.001). After 3 years, MACE rate was significantly lower in the modi-MC group (25.4% vs. 12.6%, p =0.030). The incidence of all-cause death was 7.5% vs. 2.7% (p =0.087), MI was 4.5% vs. 1.8% (p =0.290), TLR was 17.4% vs. 8.9% (p =0.093) and stent thrombosis was 3.0% vs. 1.8% (p =0.632) in the Crush and modi-MC groups, respectively.
CONCLUSIONS: The modified mini-crush technique showed more favorable 3-year clinical outcomes compared to the classic crush technique.
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