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Date Published: 29/10/2024
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DOI: https://doi.org/10.51298/vmj.v543i3.11574
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Vol. 543 No. 3 (2024)
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Ngô, M. H., Phạm, T. H. L., & Võ , C. (2024). DOUBLE KISSING MINI-CULOTTE TECHNIQUE FOR TRUE CORONARY BIFURCATION LESIONS: A PROSPECTIVE STUDY, SINGLE CENTER. Vietnam Medical Journal, 543(3). https://doi.org/10.51298/vmj.v543i3.11574

DOUBLE KISSING MINI-CULOTTE TECHNIQUE FOR TRUE CORONARY BIFURCATION LESIONS: A PROSPECTIVE STUDY, SINGLE CENTER

Minh Hùng Ngô, Tấn Hoàng Long Phạm, Cường Võ

Main Article Content

Abstract

Background: Classic Culotte Technique with DES (CC) for true coronary bifurcation lesions (tCBL) showed controversial results, in which, DKC III showed limitations of CC vs DKC at POC and main branch (9.19% vs 4.55% and 12.64% vs 6.82%) respectively. DK-Mini-Culotte Technique (DKmCU) with new generation DES showed better outcomes in recent trials. Aim: To examine the feasibility, safety and efficacy of DKmCU for tCBL. Methods: This is a prospective study with 1-year follow-up. The primary clinical endpoints were the major adverse cardiovascular events (MACE), which included cardiovascular death, nonfatal myocardial infarction and non-fatal stroke. The secondary endpoints were clinical target vessel/lesion revascularization (TVR/TLR), stent thrombosis, in-stent restenosis. Results: This cohort included 37 consecutive patients with tCBLs (Medina type 1,1,1; 1,0,1; 0,1,1). Average age was 66.24 ± 10.81 yrs and male patients are 23 (62,2%). All the eligible patients underwent percutaneous coronary intervention (PCI) with two-stent techniques in our hospital. The distribution of tCBLs is LMCA-LAD/LCx (35.1%); pLAD-mLAD/D (54.1%); dRCA-PLV/PDA (8.1%) and pLCx-dLCx/OM (2.7%). QCA analysis (at baseline) showed that the length, diameter and diameter stenosis of main vessel lesions are 33.27±10.49mm, 3.08±0.40mm and 81.22 ± 12.50% and the length, diameter and diameter stenosis of main vessel lesions of side branch 24.78±8.42mm, 2.93±0.40mm and 86.05 ± 9.90%. Technique success rate was 100% without any peri-procedure complications. There was one cardiogenic shock patient (2.7%) died in hospital due to severe pneumonia and multi-organ failure and another patient (2.7%) died at home during COVID-19 lock-down. There were no other clinical indications for repeat revascularization reported at 1 year follow up for other patients. Conclusion: DKmCU technique was associated with lower rate of cumulative MACE, and TVR/TLR, and is as effective as other techniques in treating tCBLs, however, this needs to be further confirmed by a randomized clinical trial.

Article Details

Keywords

true coronary bifurcation lesion, culotte technique, percutaneous coronary intervention

References

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