Chen S L, Zhang J J, Ye F, Chen Y D, Patel T, Kawajiri K, Lee M, Kwan T W, Mintz G, Tan H C
Cardiological Department, Nanjing First Hospital of Nanjing Medical University, Nanjing, China.
Eur J Clin Invest. 2008 Jun;38(6):361-71. doi: 10.1111/j.1365-2362.2008.01949.x.
Classical crush has a lower rate of final kissing balloon inflation (FKBI) immediately after percutaneous coronary intervention (PCI). The double kissing (DK) crush technique has the potential to increase the FKBI rate, and no prospective studies on the comparison of classical with DK crush techniques have been reported.
Three hundred and eleven patients with true bifurcation lesions were randomly divided into classical (n = 156) and DK crush (n = 155) groups. Clinical and angiographic details at follow-up at 8 months were indexed. The primary end point was major adverse cardiac events (MACE) including myocardial infarction, cardiac death and target lesion revascularization (TLR) at 8 months.
FKBI was 76% in the classical crush group and 100% in the DK group (P < 0.001). The incidence of stent thrombosis was 3.2% in the classical crush group (5.1% in without- and 1.7% in with-FKBI) and 1.3% in the DK crush group. Cumulative 8 month MACE was 24.4% in the classical crush group and 11.4% in the DK crush group (P = 0.02). The TLR-free survival rate was 75.4% in the classical crush group and 89.5% in the DK crush group (P = 0.002).
DK crush technique has the potential of increasing FKBI rate and reducing stent thrombosis, with a further reduction of TLR and cumulative MACE rate at 8 months.
在经皮冠状动脉介入治疗（PCI）后，传统挤压术的最终球囊对吻扩张（FKBI）率较低。双对吻（DK）挤压技术有可能提高FKBI率，且尚无关于传统挤压术与DK挤压术比较的前瞻性研究报道。
311例真性分叉病变患者被随机分为传统挤压术组（n = 156）和DK挤压术组（n = 155）。记录8个月随访时的临床和血管造影详细情况。主要终点是8个月时的主要不良心脏事件（MACE），包括心肌梗死、心源性死亡和靶病变血运重建（TLR）。
传统挤压术组的FKBI为76%，DK组为100%（P < 0.001）。传统挤压术组的支架血栓形成发生率为3.2%（未进行FKBI者为5.1%，进行FKBI者为1.7%），DK挤压术组为1.3%。传统挤压术组8个月累积MACE为24.4%，DK挤压术组为11.4%（P = 0.02）。传统挤压术组无TLR生存率为75.4%，DK挤压术组为89.5%（P = 0.002）。
DK挤压技术有可能提高FKBI率并减少支架血栓形成，进一步降低8个月时的TLR和累积MACE率。
