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Clinical outcome after crush versus culotte stenting of coronary artery bifurcation lesions: the Nordic Stent Technique Study 36-month follow-up results.

https://arctichealth.org/en/permalink/ahliterature106024
Source
JACC Cardiovasc Interv. 2013 Nov;6(11):1160-5
Publication Type
Article
Date
Nov-2013
Author
Kari Kervinen
Matti Niemelä
Hannu Romppanen
Andrejs Erglis
Indulis Kumsars
Michael Maeng
Niels R Holm
Jens F Lassen
Pål Gunnes
Sindre Stavnes
Jan S Jensen
Anders Galløe
Inga Narbute
Dace Sondore
Evald H Christiansen
Jan Ravkilde
Terje K Steigen
Jan Mannsverk
Per Thayssen
Knud Nørregaard Hansen
Steffen Helqvist
Saila Vikman
Rune Wiseth
Jens Aarøe
Jari Jokelainen
Leif Thuesen
Author Affiliation
Division of Cardiology, Department of Medicine, Oulu University Hospital, Oulu, Finland. Electronic address: kari.kervinen@ppshp.fi.
Source
JACC Cardiovasc Interv. 2013 Nov;6(11):1160-5
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Agents - administration & dosage
Coronary Angiography
Coronary Artery Disease - diagnosis - mortality - therapy
Coronary Restenosis - etiology
Coronary Thrombosis - etiology
Drug-Eluting Stents
Female
Finland
Humans
Latvia
Male
Middle Aged
Percutaneous Coronary Intervention - adverse effects - instrumentation - methods - mortality
Prosthesis Design
Risk factors
Scandinavia
Sirolimus - administration & dosage
Time Factors
Treatment Outcome
Abstract
The aim of the study was to compare long-term follow-up results of crush versus culotte stent techniques in coronary bifurcation lesions.
The randomized Nordic Stent Technique Study showed similar 6-month clinical and 8-month angiographic results with the crush and culotte stent techniques of de novo coronary artery bifurcation lesions using sirolimus-eluting stents. Here, we report the 36-month efficacy and safety of the Nordic Stent Technique Study.
A total of 424 patients with a bifurcation lesion were randomized to stenting of both main vessel and side branch with the crush or the culotte technique and followed for 36 months. Major adverse cardiac events-the composite of cardiac death, myocardial infarction, stent thrombosis, or target vessel revascularization-were the primary endpoint.
Follow-up was complete for all patients. At 36 months, the rates of the primary endpoint were 20.6% versus 16.7% (p = 0.32), index lesion restenosis 11.5% versus 6.5% (p = 0.09), and definite stent thrombosis 1.4% versus 4.7% (p = 0.09) in the crush and the culotte groups, respectively.
At 36-month follow-up, the clinical outcomes were similar for patients with coronary bifurcation lesions treated with the culotte or the crush stent technique. (Nordic Bifurcation Study. How to Use Drug Eluting Stents [DES] in Bifurcation Lesions? NCT00376571).
PubMed ID
24262616 View in PubMed
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Randomized comparison of coronary bifurcation stenting with the crush versus the culotte technique using sirolimus eluting stents: the Nordic stent technique study.

https://arctichealth.org/en/permalink/ahliterature98527
Source
Circ Cardiovasc Interv. 2009 Feb;2(1):27-34
Publication Type
Article
Date
Feb-2009
Author
Andrejs Erglis
Indulis Kumsars
Matti Niemelä
Kari Kervinen
Michael Maeng
Jens F Lassen
Pål Gunnes
Sindre Stavnes
Jan S Jensen
Anders Galløe
Inga Narbute
Dace Sondore
Timo Mäkikallio
Kari Ylitalo
Evald H Christiansen
Jan Ravkilde
Terje K Steigen
Jan Mannsverk
Per Thayssen
Knud Nørregaard Hansen
Mikko Syvänne
Steffen Helqvist
Nikus Kjell
Rune Wiseth
Jens Aarøe
Mikko Puhakka
Leif Thuesen
Author Affiliation
Latvian Centre of Cardiology, Paul Stradins Clinical University Hospital, Riga, Latvia. a.a.erglis@stradini.lv
Source
Circ Cardiovasc Interv. 2009 Feb;2(1):27-34
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Transluminal, Percutaneous Coronary - adverse effects - instrumentation - mortality
Biological Markers - blood
Cardiovascular Agents - administration & dosage
Coronary Angiography
Coronary Artery Disease - mortality - radiography - therapy
Coronary Restenosis - etiology - mortality - prevention & control - radiography
Denmark - epidemiology
Drug-Eluting Stents
Female
Finland - epidemiology
Humans
Kaplan-Meiers Estimate
Latvia - epidemiology
Male
Middle Aged
Myocardial Infarction - etiology
Norway - epidemiology
Prosthesis Design
Sirolimus - administration & dosage
Thrombosis - etiology
Time Factors
Treatment Outcome
Abstract
BACKGROUND: In a number of coronary bifurcation lesions, both the main vessel and the side branch need stent coverage. Using sirolimus eluting stents, we compared 2 dedicated bifurcation stent techniques, the crush and the culotte techniques in a randomized trial with separate clinical and angiographic end-points. METHODS AND RESULTS: A total of 424 patients with a bifurcation lesion were randomized to crush (n=209) and culotte (n=215) stenting. The primary end point was major adverse cardiac events; cardiac death, myocardial infarction, target vessel revascularization, or stent thrombosis after 6 months. At 6 months there were no significant differences in major adverse cardiac event rates between the groups; crush 4.3%, culotte 3.7% (P=0.87). Procedure and fluoroscopy times and contrast volumes were similar in the 2 groups. The rates of procedure-related increase in biomarkers of myocardial injury were 15.5% in crush versus 8.8% in culotte group (P=0.08). A total of 324 patients had a quantitative coronary assessment at the index procedure and after 8 months. The angiographic end-points of in-segment and in-stent restenosis of main vessel and/or side branch after 8 months were found in 12.1% versus 6.6% (P=0.10) and in 10.5% versus 4.5% (P=0.046) in the crush and culotte groups, respectively. CONCLUSIONS: Both the crush and the culotte bifurcation stenting techniques were associated with similar and excellent clinical and angiographic results. Angiographically, there was a trend toward less in-segment restenosis and significantly reduced in-stent restenosis following culotte stenting.
PubMed ID
20031690 View in PubMed
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