RESUMO
OBJECTIVES: To compare the very long-term clinical outcomes of bifurcation lesions using the crush and the simultaneous kissing stent (SKS) techniques. BACKGROUND: A variety of two-stent techniques have been used to treat coronary artery bifurcation lesions in the drug-eluting stent era, but the long-term clinical outcome of these approaches is not known. METHODS: A total of 74 consecutive patients underwent bifurcation stenting using either the crush or SKS techniques. Mean patient age was 66.91 + or - 11.3 years; 26% were diabetic, and the left anterior descending/diagonal bifurcation was the most frequently treated lesion (68%). RESULTS: In-hospital outcomes were not significantly different between groups. Over a median follow-up of 3.3 years, 1 patient in the SKS group and 3 patients in the crush group died (P = ns). Probable stent thrombosis leading to death according to the Academic Research Consortium definition occurred in 1 patient in the crush group. Mortality in the remaining 3 patients was noncardiac. Target lesion revascularization (TLR) occurred in 14 patients (40%) in the SKS group and 5 patients (12.8%) in the crush group (P = 0.015). Survival free from major adverse cardiac events (MACE) was significantly less in the SKS group and predominantly driven by TLR (60 vs. 88%, P = 0.001). CONCLUSIONS: In conclusion, over a median of 3.3 years of follow-up, TLR and MACE are significantly lower in bifurcation lesions treated with the crush technique when compared with the SKS technique. Definite or probable stent thrombosis is rare with either technique.