TY - JOUR JO - EuroIntervention TI - Double-kissing culotte technique for coronary bifurcation stenting AB - <p><strong>Aims:</strong> The aim of this study was to assess whether the culotte technique could be improved by an additional kissing dilation prior to main branch (MB) stenting.</p> <p><strong>Methods and results:</strong> Double-kissing (DK) culotte was compared to the culotte and DK-crush techniques in a bench model (n=24). Results were evaluated for stent apposition, luminal opening and flow dynamics. The total procedure duration of DK-culotte was 18.3&plusmn;3.4 minutes, significantly lower than for DK-crush (24.3&plusmn;5.7 min; p=0.015), but similar to culotte (21.6&plusmn;5.9 min, p=0.104). In DK-culotte the overall rate of moderate (200-500 &micro;m) and significant (&gt;500 &micro;m) malapposition was 2.1&plusmn;1.9% and 0.4&plusmn;0.2%, similar as compared to culotte (3.7&plusmn;3.8%, p=0.459 and 1.0&plusmn;1.0%, p=0.517, respectively), and lower as compared to DK-crush (8.1&plusmn;2.5%, p&lt;0.001 and 3.7&plusmn;5.3%, p=0.002, respectively). The lower malapposition rate of DK-culotte as compared to DK-crush was due to less moderate and significant malapposition in the proximal MB (0.0&plusmn;0.0% vs 14.0&plusmn;7.6%, p&lt;0.001 and 0.0&plusmn;0.0% vs 4.2&plusmn;9.1%, p=0.026, respectively). Micro-computed tomography did not show a difference in luminal opening at the proximal MB, distal MB or SB. There was no difference either in the maximum shear rate or in areas of high shear or recirculation.</p> <p><strong>Conclusions:</strong> Bench test data suggest that the DK approach facilitates the culotte technique. The clinical validity and relevance remain to be confirmed in a larger in vivo population.</p> AU - Toth Gabor G. AU - Sasi Viktor AU - Franco Danilo AU - Prassl J. Anton AU - Diserafino Luigi AU - Ng C.K. Jaryl AU - Szanto Gyula AU - Schneller Laura AU - Ang Ying Hui AU - Plank Gernot AU - Wijns William AU - Barbato Emanuele VL - 16 IS - 9 Y1 - 09/10/2020 Y1 - 2020 DOI - 10.4244/EIJ-D-20-00130 SP - e724 EP - e733 KW - bifurcation KW - drug-eluting stent KW - left main PB - Europa Digital & Publishing SE - Coronary interventions - Mini focus on bifurcation lesions UR - https://eurointervention.pcronline.com/article/double-kissing-culotte-technique-for-coronary-bifurcation-stenting-technical-evaluation-and-comparison-with-conventional-double-stenting-techniques SN - 1774-024X ER -