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Drug‐eluting stents for coronary bifurcations: Insights into the crush technique
Author(s) -
Ormiston John A.,
Currie Erin,
Webster Mark W.I.,
Kay Patrick,
Ruygrok Peter N.,
Stewart James T.,
Padgett Richard C.,
Panther Monique J.
Publication year - 2004
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20120
Subject(s) - ostium , medicine , restenosis , percutaneous coronary intervention , stent , balloon , drug eluting stent , radiology , surgery , cardiology , myocardial infarction
Sirolimus‐eluting stents appear to reduce substantially restenosis following percutaneous coronary bifurcation intervention. The crush technique was devised to reduce restenosis further by improving stent and drug application to the side‐branch ostium. We aimed to investigate the performance of drug‐eluting stent (DES) platforms with the crush technique, to identify deployment pitfalls, and to clarify the best deployment strategies. Each stage of the crush technique was photographed in a bifurcation phantom. Simultaneous side‐ and main‐branch dilatation (kissing balloons) fully expanded the stent in the side‐branch ostium, widened the gaps between stent struts covering the side branch, and eliminated main‐branch distortion. With side branches angled at > 70°, sequential (side‐ then main‐branch) inflations may be needed to achieve best results. Postdilatation of the main branch with a balloon of narrower diameter than the deploying balloon caused main‐branch stent distortion. These principles applied to all the bifurcation strategies and stent designs tested. Cathet Cardiovasc Interv 2004;63:332–336. © 2004 Wiley‐Liss, Inc.