Mini-crush or Nano-crush Stenting Technique for Complex Coronary Bifurcation Lesions: the Multicenter MINANO Registry

Abstract

Background: In this multicenter study we aimed to retrospectively identify the midterm clinical outcomes of the mini-crush technique (MCT) and nano-crush technique (NCT) in patients with complex bifurcation lesions (CBLs).

Methods: The study included 431 patients (318 men [73.8%], mean age 60.96 ± 10.34 years) from 6 tertiary centers who underwent bifurcation percutaneous coronary intervention between January 2018 and December 2023. The primary endpoint was defined as the major cardiovascular events (MACEs) of cardiac death, target vessel myocardial infarction (TVMI), or clinically driven target lesion revascularization (TLR). To our knowledge, this study is the first to compare clinical outcomes of the MCT and NCT in patients with CBLs.

Results: The initial revascularization strategy was MCT in 302 (70%) patients and NCT in 129 (30%) patients. SYNTAX scores (24.33 ± 6.54 vs 24.43 ± 5.45, P = 0.707) were comparable between groups. MACEs (18.6% vs 10.9%, P = 0.031), TVMIs (11.6% vs 5.6%, P = 0.030), and clinically driven TLRs (14% vs 6%, P = 0.006) were significantly more prevalent in the NCT group than in the MCT group. Being in the MCT group (hazard ratio [HR] 0.549, P = 0.035), high SYNTAX score (HR 1.105, P < 0.001), nonfatal intraprocedural 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 MACEs.

Conclusions: The findings of this nonrandomized study suggest that the MCT was associated with better midterm MACE, TVMI, and clinically driven TLR rates compared with NCT in patients with CBLs.