A novel technique for coronary bifurcation intervention: Double rewire crush technique and its clinical outcomes after 2 years of follow‐up


OBJECTIVES: 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.

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

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Zhang D, He Y, Yan R, et al. Catheter Cardiovasc Interv 2019;93:851–8.