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With drug-eluting stents, is the 'crush' or 'culotte' technique better?

CHICAGO, March 29 /PRNewswire/ -- When stenting is performed for an arterial narrowing at the branchpoint of two coronary arteries -- or a bifurcation lesion -- it can be challenging to achieve full coverage of both vessels without blocking the opening to the side branch. A new study will provide interventional cardiologists with new information on which of two techniques produces the best long-term results when used with a drug-eluting stent.

The Nordic Stent Technique Study will be reported today in a Late-Breaking Clinical Trials session at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit (SCAI-ACCi2) in Chicago. SCAI-ACCi2 is a scientific meeting for practicing cardiovascular interventionalists sponsored by the Society for Cardiovascular Angiography and Interventions (SCAI) in partnership with the American College of Cardiology (ACC).

The study, led by Paal Gunnes, MD, Feiring Klinikken, Feiring, Norway, will compare the "culotte" and "crush" techniques. With the culotte technique, two similar stents are threaded into the diseased artery. One is positioned in the main artery and the other in the side branch, so that the two stents overlap in the main artery before the branchpoint. With the crush technique, the side branch stent is positioned so that a small portion protrudes into the main artery. When the stent in the main artery is expanded, it completely covers and crushes the protruding segment of the side-branch stent against the wall of the main artery.

For the study, Dr. Gunnes and his colleagues recruited 425 patients with bifurcation lesions, randomly assigning them to treatment with a drug-eluting stent implanted using either a culotte or crush technique. A total of 345 patients are expected to have had quantitative coronary angiography both at the time of stenting and after eight months of follow-up. The researchers will report
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