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For the Nordic-Baltic PCI Study Group
Eight Months Angiographic Follow-up in Patients Randomized to Crush or Culotte Stenting of Coronary Artery Bifurcation Lesions The Nordic Bifurcation Stent Technique Study Pål Gunnes, Matti Niemela, Kari Kervinen, Andrejs Erglis, Indulis Kumsars, Jens F Lassen, Michael Mæng, Jan Skov Jensen, Anders Galløe, Terje Steigen, Jan Ravkilde, Timo Makikallio, Kari Ylitalo, Inga Narbute, Evald Christiansen, Lars Krusell, Sindre Stavnes, Ulrik Abildgaard, Peter Riis Hansen, Jan Mannsverk, Thor Trovik, Per Thayssen, Steffen Helqvist, Saila Vikman, Rune Wiseth, Jens Aarøe, Leif Thuesen For the Nordic-Baltic PCI Study Group 1
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Stratification at randomization
CRUSH (n: 209) CULOTTE (n: 215) n: 424 (100%) Clinical Follow up, 6 months (n: 209) Clinical Follow up, 6 months (n: 215) n: 424 (100%) Stratification at randomization Scheduled Angiographic Follow up, 8 months (n: 184) Scheduled Angiographic Follow up, 8 months (n:189) n: 373 (88%) Angiographic FU available (n: 160) Angiographic FU available (n: 164) n: 324 (87%) 2
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Rate of main vessel and/or side branch
in-lesion diameter stenosis >50% at 8 months follow-up % 12.1 p=0.10 6.6 3
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Rate of main vessel and/or side branch
in-stent diameter stenosis >50% at 8 months follow-up % 10.5 p=0.046 4.5 4
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in-lesion diameter stenosis >50%
Rate of main vessel in-lesion diameter stenosis >50% at 8 months follow-up % p=0.19 4.7 2.0 5
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in-lesion diameter stenosis >50%
Rate of side branch in-lesion diameter stenosis >50% at 8 months follow-up % 9.2 p=0.10 4.5 6
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Localization of in-stent restenosis at 8 months follow-up
CRUSH CULOTTE 0.0% 0.0% 3.8%* 9.8%* 0.6% 2.0% * p=0.04 7
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Conclusion CRUSH and CULOTTE bifurcation stenting using sirolimus eluting stents were associated with low rates of restenosis at eight months angiographic follow-up The few restenoses were primarily located in side branches treated with the CRUSH technique The CULOTTE bifurcation stenting technique was associated with a single digit restenosis rate and may be preferred in suitable bifurcation anatomies Extended follow-up needed to evaluate the safety of the investigated two-stent bifurcation techniques 8
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