BACKGROUND The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment. However, their comparative performance remains elusive. METHODS A total of 300 patients with coronary bifurcation lesions were randomly assigned to crush (n = 150) and culotte (n = 150) treatment. The primary endpoint was the occurrence of major adverse cardiac events (MACEs) at 12 months including cardiac death, myocardial infarction, stent thrombosis, and target vessel revascularization. Index lesion restenosis at 12 months was a secondary endpoint. The surface integrals of time-averaged wall shear stress at bifurcation sites were also be quantified. RESULTS There were no significant differences in MACE rates between the two groups at 12-month follow-up: Crush 6.7%, culotte 5.3% (P = 0.48). The rates of index lesion restenosis were 12.7% versus 6.0% (P = 0.047) in the crush and the culotte groups, respectively. At 12-month follow-up, the surface integrals of time-averaged wall shear stress at bifurcation sites in the crush group were significantly lower than the culotte group ([5.01 ± 0.95] × 10-4 Newton and [6.08 ± 1.16] × 10-4 Newton, respectively; P = 0.003). CONCLUSIONS Both the crush and the culotte bifurcation stenting techniques showed satisfying clinical and angiographic results at 12-month follow-up. Bifurcation lesions treated with the culotte technique tended to have lower restenosis rates and more favorable flow patterns.

中文翻译：

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冠状动脉分叉病变的粉碎与裙带支架的随机比较。

背景技术据报道，挤压和滑脱支架都对复杂的分叉病变治疗有效。但是，它们的比较性能仍然难以捉摸。方法总共将300例冠状动脉分叉病变患者随机分为挤压（n = 150）和滑脱（n = 150）治疗。主要终点是发生在12个月的主要不良心脏事件（MACE），包括心脏死亡，心肌梗塞，支架血栓形成和靶血管血运重建。次要终点是12个月时的指标病变再狭窄。还对分叉部位时均壁剪应力的表面积分进行了量化。结果在12个月的随访中，两组之间的MACE率无显着差异：粉碎率6.7％，滑槽肌5.3％（P = 0.48）。挤压组和滑槽组的指数病变再狭窄发生率分别为12.7％和6.0％（P = 0.047）。在12个月的随访中，挤压组中分叉部位的平均时间壁面剪应力的表面积分显着低于滑坡组（[5.01±0.95]×10-4 Newton和[6.08±1.16]×分别为10-4牛顿； P = 0.003）。结论在12个月的随访中，挤压和滑行分叉支架置入术均显示出令人满意的临床和血管造影结果。用滑脱法治疗的分叉病变倾向于具有较低的再狭窄率和更有利的血流模式。挤压组在分叉部位的平均时间壁面剪应力的表面积分显着低于滑坡组（分别为[5.01±0.95]×10-4牛顿和[6.08±1.16]×10-4牛顿； P = 0.003）。结论在12个月的随访中，挤压和滑行分叉支架置入术均显示出令人满意的临床和血管造影结果。用滑脱法治疗的分叉病变倾向于具有较低的再狭窄率和更有利的血流模式。挤压组在分叉部位的平均时间壁面剪应力的表面积分显着低于滑坡组（分别为[5.01±0.95]×10-4牛顿和[6.08±1.16]×10-4牛顿； P = 0.003）。结论在12个月的随访中，挤压和滑行分叉支架置入术均显示出令人满意的临床和血管造影结果。用滑脱法治疗的分叉病变倾向于具有较低的再狭窄率和更有利的血流模式。