SynthesisClinical research in cardiology : official journal of the German Cardiac Society2022
Stenting techniques for coronary bifurcation disease: a systematic review and network meta-analysis demonstrates superiority of double-kissing crush in complex lesions.
Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Development and validation of a predictive model for side branch flow impairment following stent implantation in patients with non-left main coronary bifurcation lesions: a retrospective analysis.BMC cardiovascular disorders · 2026Article
- Challenges and Optimization of Percutaneous Coronary Interventions for Coronary Bifurcation Lesions.Reviews in cardiovascular medicine · 2026Review
- Comparison of Different Double-Stent Implantation Techniques on Coronary Bifurcation Lesions: A Finite Element Analysis.Current cardiology reviews · 2026Article
- Navigating the Left Main Bifurcation: Which Stenting Strategy Best Minimises Major Adverse Cardiac Events and Target Lesion Revascularisation? A Network Meta-analysis.Interventional cardiology (London, England) · 2026Review
- Advancements in Coronary Bifurcation Stenting Techniques: Insights From Computational and Bench Testing Studies.International journal for numerical methods in biomedical engineering · 2025Review
- Stent thrombosis: a contemporary guide to definitions, risk factors, and management.Frontiers in cardiovascular medicine · 2025Review
- Comparing the clinical outcomes of single vs. systematic dual stenting strategies for unprotected left main bifurcation lesion: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2023Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThis study was aimed to compare different stenting techniques for coronary bifurcation disease (CBD).
backgroundPercutaneous coronary intervention (PCI) remains controversial for CBD; over the years, several stent techniques for bifurcation lesions have been used. Current guidelines recommend a provisional single-stent strategy as the preferred method for coronary artery bifurcation lesions. However, several randomized controlled trials (RCT) indicated that two-stent techniques showed better clinical outcomes.
methodsWe systematically searched Embase, PubMed, and Web of Science to include RCTs. The primary endpoint was the major adverse cardiovascular event (MACE). Secondary outcomes were cardiac death, myocardial infarction (MI), target-lesion or target-vessel revascularization (TLR or TVR), and definite or probable stent thrombosis (ST). Finally, we used 26 RCTs and a total of 7257 individuals were randomly assigned to one of the 6 stent techniques and included in this network meta-analysis.
resultsIn our network meta-analysis, double-kissing (DK) crush was significantly more superior to other 5 stent techniques in MACEs: OR vs. provisional 0.40 (95% CI 0.28-0.55); vs. culotte 0.40 (95% CI 0.26-0.60). DK crush ranked the most effective treatment for MACE (100%), MI (75%), ST (83%), and TLR (100%) in the rank probabilities analysis. In patients with complex bifurcation lesion defined by DEFINITION criteria, DK crush was notably more efficacious than provisional, culotte, and T-stenting/T-stenting and protrusion (TAP) in MACEs (OR vs. provisional 0.26, 95% CI 0.13-0.52) and TLR (OR vs. provisional 0.24, 95% CI 0.10-0.58).
conclusionCompared with other stenting techniques, DK crush had a lower incidence of MACEs in CBD. DK crush was significantly associated with a lower rate of MACEs in patients with complex bifurcation lesions defined by the DEFINITION criterion.
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Registered trials
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