State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Catheter Cardiovasc Interv. 2019 Feb 15;93(S1):851-858. doi: 10.1002/ccd.28066. Epub 2019 Jan 2.
To describe procedural details of the double rewire (DR) crush technique, a novel modified crush technique, and report the clinical outcomes of patients who underwent the procedure.
In the management of complex bifurcation lesions, there is a need to use elective two-stent techniques that stent the side branch (SB) before main vessel (MV) stenting and keep SB open.
We studied 48 patients with 49 bifurcation lesions who underwent percutaneous coronary intervention (PCI) using the DR-crush technique between January and December 2013. Baseline, postprocedural, and follow-up quantitative coronary angiographic analyses were performed. Procedural characteristics and clinical outcomes at follow-up were assessed.
Majority of the patients (60.4%, 29/48) had acute coronary syndrome. Most bifurcation lesions (77.6%, 38/49) were classified as Medina 1, 1, 1. Final kissing balloon inflation was successfully performed in all patients. After PCI, MV and SB of all patients had Thrombolysis In Myocardial Infarction 3 blood flow. None of the patients had MV or SB diameter stenosis ≥50% after PCI. At a mean follow-up period of 2.4 years, target vessel revascularization occurred in 2.1% and myocardial infarction in 2.1%. No deaths occurred in this period.
The DR-crush technique is feasible in coronary bifurcation stenting. Patients who underwent this procedure had relatively low incidence of adverse events. Larger studies are warranted for further confirmation of the findings.
描述一种新的改良 crush 技术——双重绞轧（DR）技术的操作细节，并报告接受该手术的患者的临床结果。
在复杂分叉病变的治疗中，需要使用选择性双支架技术，即在主血管（MV）支架置入前对边支（SB）进行支架置入以保持 SB 通畅。
我们研究了 2013 年 1 月至 12 月期间接受 DR-crush 技术经皮冠状动脉介入治疗（PCI）的 48 例 49 处分叉病变患者。进行了基线、术后和随访的定量冠状动脉造影分析。评估了手术特点和随访时的临床结果。
大多数患者（60.4%，29/48）患有急性冠脉综合征。大多数分叉病变（77.6%，38/49）为 Medina 1,1,1 型。所有患者均成功进行了最终的对吻球囊扩张。PCI 后，所有患者的 MV 和 SB 均有心肌梗死溶栓治疗 3 级血流。PCI 后，所有患者的 MV 或 SB 直径狭窄均<50%。在平均 2.4 年的随访期间，2.1%的患者发生了靶血管血运重建，2.1%的患者发生了心肌梗死。在此期间无死亡病例。
DR-crush 技术在冠状动脉分叉支架置入中是可行的。接受该手术的患者不良事件发生率相对较低。需要更大规模的研究来进一步证实这些发现。
