Background: This multicenter study aimed to retrospectively evaluate the mid-term clinical outcomes of mini-crush (MCT) and nano-crush (NCT) techniques in patients with complex bifurcation lesions (CBLs).
Methods: The study comprised 431 patients [male: 318 (73.8%), mean age: 60.96 ± 10.34 years] who underwent bifurcation PCI between January 2018 and December 2023 were included in the study from six tertiary centers. The primary endpoint was defined as the major cardiovascular events (MACE), which include cardiac death, target vessel myocardial infarction (TVMI), or clinically driven target lesion revascularization (TLR). This is the first study to compare the clinical outcomes of MCT and NCT in patients with CBL.
Results: The initial revascularization strategy was MCT in 302 (70%) cases and NCT in 129 (30%) patients. SYNTAX scores [24.33±6.54 vs 24.43±5.45, p=0.707] were comparable in both groups. The incidence of MACE (18.6 vs. 10.9%, p=0.031), TVMI (11.6 vs 5.6%, p=0.030), and clinically driven TLR (14 vs. 6%, p=0.006) were significantly higher in the NCT group compared to the MCT group. Being in the MCT group (HR: 0.549, p=0.035), high SYNTAX score (HR: 1.105, p<0.001), non-fatal intra-procedural complications (HR: 3.269, p<0.001), proximal side-branch optimization (HR: 0.451, p=0.013), diabetes mellitus (HR: 2.263, p=0.009), and chronic kidney disease (HR: 1.948, p=0.024) were found to be independent predictors of MACE.
Conclusion: This non-randomized study suggests that MCT was associated with better mid-term MACE, TVMI, and clinically driven TLR rates compared with NCT in patients with CBLs.
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