Objectives The conventional culotte stenting remains not to be widely used for treating coronary bifurcation lesions (CBLs) due to the potential risk of intra-procedural vessel occlusion, requirement of similar branch size and relatively higher rate of restenosis of the side branch (SB). To evaluated efficacy and safety of a novel culottestenting, double kissing mini-culotte stenting (DK mini-culotte) used in patients with true CBLs.
Methods A total of 45 consecutive patients with true CBL according to Medina’s classification were included in this study for DK mini-culotte stenting, which was characterised by stenting the smaller SB first, mini-protrusion (1–2 mm) of the first stent into the parent vessel, and performing double-balloon kissing inflation two times. The immediate and 9-month outcomes were prospectively evaluated.
Results The immediate angiographic success rate was 100% per lesions or per patients, with 100% success of final double-balloon kissing inflation. The procedural time was 41.2 ± 13.7 minutes and the fluoroscopy time was 21.6 ± 8.7 minutes. Clinical follow up was completed in all patients and angiographic follow up in 44 patients (97.8%). The clinical success rate was 95.6%. There were no all-cause death, myocardial infarction, and in-stent thrombosis. At 9 months, the defined restenosis was found only at 2 sites from 2 patients (4.4%), one of which underwent target lesion revascularisation due to the edge restenosis of main branch (MB). Quantitative coronary angiography data showed that late lumen loss was acceptable with (0.10 ± 0.09) mm for the parent vessel, (0.17 ± 0.15) mm for the MB and (0.22 ± 0.26) mm for the SB.
Conclusions DK mini-culotte technique for treatment of true BLs was technically feasible and was associated with highangiographic and procedural success, and optimal 9-month outcomes.