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Takagi K, Nagoshi R, Kim BK, Kim W, Kinoshita Y, Shite J, Hikichi Y, Song YB, Nam CW, Koo BK, Kim SJ, Murasato Y. Efficacy of coronary imaging on bifurcation intervention. Cardiovasc Interv Ther 2020; 36:54-66. [PMID: 32894433 PMCID: PMC7829226 DOI: 10.1007/s12928-020-00701-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 01/14/2023]
Abstract
During the coronary bifurcation intervention procedure, imaging including intravascular ultrasound and optical coherence tomography is essential to provide precise anatomy of the lesion and morphological information. This consensus document between the Korean Bifurcation Club and the Japanese Bifurcation Club summarizes practical guidelines and current evidences on lesion assessment, device selection, procedural guidance, and the optimization of bifurcation intervention by the imaging.
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Affiliation(s)
- Kensuke Takagi
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Ryoji Nagoshi
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Byeong-Keuk Kim
- Department of Cardiology, Yonsei Severance Hospital, Seoul, South Korea
| | - Woong Kim
- Department of Cardiology, Yeungnam Medical Center, Daegu, South Korea
| | - Yoshihisa Kinoshita
- Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan
| | - Junya Shite
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | | | - Young Bin Song
- Department of Cardiology, Samsung Medical Center, Seoul, South Korea
| | - Chang-Wook Nam
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, South Korea
| | - Bon-Kwon Koo
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Soo-Joong Kim
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Yoshinobu Murasato
- Department of Cardiology and Clinical Research Center, National Hospital Organization, Kyushu Medical Center, 1-8-1, Jigyohama, Chuo, Fukuoka, 810-8563, Japan.
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Chen SL, Santoso T, Zhang JJ, Ye F, Xu YW, Fu Q, Kan J, Zhang FF, Zhou Y, Xie DJ, Kwan TW. Clinical Outcome of Double Kissing Crush Versus Provisional Stenting of Coronary Artery Bifurcation Lesions: The 5-Year Follow-Up Results From a Randomized and Multicenter DKCRUSH-II Study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions). Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.116.004497. [PMID: 28122805 PMCID: PMC5319391 DOI: 10.1161/circinterventions.116.004497] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/23/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush stenting reduces the 1-year rate of target lesion revascularization. This study aimed to investigate the 5-year clinical results of the DKCRUSH-II study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions). METHODS AND RESULTS A total of 370 patients with coronary bifurcation lesions who were randomly assigned to either the double kissing crush or provisional stenting group in the DKCRUSH-II study were followed for 5 years. The primary end point was the occurrence of a major adverse cardiac event at 5 years. Patients were classified by simple and complex bifurcation lesions according to the DEFINITION criteria (Definitions and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents). At 5 years, the major adverse cardiac event rate (23.8%) in the provisional stenting group was insignificantly different to that of the double kissing group (15.7%; P=0.051). However, the difference in the target lesion revascularization rate between 2 groups was sustained through the 5-year follow-up (16.2% versus 8.6%; P=0.027). The definite and probable stent thrombosis rate was 2.7% in each group (P=1.0). Complex bifurcation was associated with a higher rate of target lesion revascularization (21.6%) at 5 years compared with 11.1% in patients with a simple bifurcation (P=0.037), with an extremely high rate in the provisional stenting group (36.8% versus 12.5%, P=0.005) mainly because of final kissing balloon inflation (19.4% versus 5.2%; P=0.036). CONCLUSIONS The double kissing crush stenting technique for coronary bifurcation lesions is associated with a lower rate of target lesion revascularization. The optimal stenting approach based on the lesions' complexity may improve the revascularization for patients with complex bifurcations. CLINICAL TRIAL REGISTRATION URL: http://www.chictr.org. Unique identifier: ChiCTR-TRC-0000015.
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Affiliation(s)
- Shao-Liang Chen
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.).
| | - Teguh Santoso
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Jun-Jie Zhang
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Fei Ye
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Ya-Wei Xu
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Qiang Fu
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Jing Kan
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Feng-Fu Zhang
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Yong Zhou
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Du-Jiang Xie
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
| | - Tak W Kwan
- From the Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, China (S.-L.C., J.-J.Z., F.Y., J.K., F.-F.Z.); Division of Cardiology, Medistra Hospital, University of Indonesia Medical School, Jakarta (T.S.); Division of Cardiology, Shanghai 10th People's Hospital, China (Y.-W.X.); Division of Cardiology, Xuzhou Central Hospital, China (Q.F.); Division of Cardiology, Zhangjiagang People's Hospital, China (Y.Z.); Division of Cardiology, Huainan Xinhua Hospital, China (D.-J.X.); and Division of Cardiology, Beth Israel Hospital, New York, NY (T.W.K.)
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