cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2022-37-1-162-169cardiotomsk-1368Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCLINICAL CASESКлинический случай успешного эндоваскулярного лечения поражения ствола левой коронарной артерии с использованием техники DK-CRUSH под контролем оптической когерентной томографииSuccessful endovascular treatment of left main bifurcation lesion using the DK-CRUSH technique with intracoronary imaging using optical coherence tomography: A case reporthttps://orcid.org/0000-0001-8265-7425СапожниковС. С.SapoznikovS. S.

младший научный сотрудник, лаборатория рентгенэндоваскулярных методов диагностики илечения Научного отдела инструментальных методов исследования,

625026, Тюмень, ул. Мельникайте, 111

Junior Research Scientist, Interventional Cardiology Laboratory, Scientific Department of Instrumental Research Methods, 

111, Melnikaite str., Tyumen, 625026

stas_ss@bk.ruhttps://orcid.org/0000-0003-0578-5962БессоновИ. С.BessonovI. S.

канд. мед. наук, заведующий лабораторией рентгенэндоваскулярных методов диагностики и лечения Научного отдела инструментальных методов исследования, 

625026, Тюмень, ул. Мельникайте, 111

Cand. Sci. (Med.), Head of Interventional Cardiology Laboratory, Scientific Department of Instrumental Research Methods, 

111, Melnikaite str., Tyumen, 625026

IvanBessnv@gmail.comhttps://orcid.org/0000-0003-4346-6671ЗыряновИ. П.ZyrianovI. P.

канд. мед. наук, руководитель отделения рентгенхирургических методов диагностики и лечения № 1, 

625026, Тюмень, ул. Мельникайте, 111

Cand. Sci. (Med.), Head of the Department of Interventional Cardiology, 

111, Melnikaite str., Tyumen, 625026

Zip@infarkta.netТюменский кардиологический научный центр, Томский национальный исследовательский медицинский центр Российской академии наукРоссияTyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of SciencesRussian Federation202209042022371162169Copyright © Сапожников С.С., Бессонов И.С., Зырянов И.П., 20222022Сапожников С.С., Бессонов И.С., Зырянов И.П.Sapoznikov S.S., Bessonov I.S., Zyrianov I.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/1368

Представлен клинический случай успешного эндоваскулярного лечения пациента с истинным бифуркационным поражением ствола левой коронарной артерии (ЛКА) с использованием техники DK-CRUSH. Описаны технические аспекты выполнения бифуркационного стентирования под контролем оптической когерентной томографии (ОКТ). Приведен обзор современного состояния проблемы выбора оптимальной техники эндоваскулярного лечения пациентов с истинным поражением ствола ЛКА. 

We report the successful endovascular treatment of true left main bifurcation lesion in a patient with chronic coronary syndrome using the DK-CRUSH technique. We describe technical aspects of bifurcation stenting with intracoronary imaging using optical coherence tomography. Here, we review the current state of the problem of choosing the optimal technique for endovascular treatment of patients with true left main true bifurcation lesion. 

ишемическая болезнь сердцаствол левой коронарной артерииDK-CRUSHоптическая когерентная томографияcoronary artery diseaseleft mainDK-CRUSHoptical coherence tomographyReferencesАлекян Б.Г., Григорьян А.М., Стаферов А.В., Карапетян Н.Г. Рентгенэндоваскулярная диагностика и лечение заболеваний сердца и сосудов в Российской Федерации – 2019 год. Эндоваскулярная хирургия. 2020;7(2S):S5–S230. DOI: 10.24183/2409-4080-2020-7-2SS5-S230.Alekyan B.G., Grigor’yan A.M., Staferov A.V., Karapetyan N.G. Endovascular diagnostics and treatment in the Russian Federation (2019). Russian Journal of Endovascular Surgery. 2020;7(2S):S5–S230. (In Russ.). DOI: 10.24183/2409-4080-2020-7-2S-S5-S230.Алекян Б.Г., Григорьян А.М., Стаферов А.В., Карапетян Н.Г. Рентгенэндоваскулярная диагностика и лечение заболеваний сердца и сосудов в Российской Федерации – 2020 год. Эндоваскулярная хирургия. 2021;8(S):S5–S248. DOI: 10.24183/2409-4080-2021-8S-S5-S248.Alekyan B.G., Grigor’yan A.M., Staferov A.V., Karapetyan N.G. Endovascular diagnostics and treatment in the Russian Federation (2020). Russian Journal of Endovascular Surgery. 2021;8(S):S5–S248. (In Russ.). DOI: 10.24183/2409-4080-2021-8S-S5-S248.Valdes P.J., Akbar H., Kahloon R.A., Diaz M.A. Intracoronary Stents. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.Valdes P.J., Akbar H., Kahloon R.A., Diaz M.A. Intracoronary Stents. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.Piccolo R., Esposito G. Device сomparisons in the new-generation drug-eluting stent era: Continued pefinements in stent technology. JACC Cardiovasc. Interv. 2020;13(9):1110–1111. DOI: 10.1016/j.jcin.2020.02.041.Piccolo R., Esposito G. Device сomparisons in the new-generation drug-eluting stent era: Continued pefinements in stent technology. JACC Cardiovasc. Interv. 2020;13(9):1110–1111. DOI: 10.1016/j.jcin.2020.02.041.Stone G.W., Kappetein A.P., Sabik J.F., Pocock S.J., Morice M.C., Puskas J. et al. Five-year outcomes after PCI or CABG for left main coronary disease. N. Engl. J. Med. 2019;381(19):1820–1830. DOI: 10.1056/NEJMoa1909406.Stone G.W., Kappetein A.P., Sabik J.F., Pocock S.J., Morice M.C., Puskas J. et al. Five-year outcomes after PCI or CABG for left main coronary disease. N. Engl. J. Med. 2019;381(19):1820–1830. DOI: 10.1056/NEJMoa1909406.Mäkikallio T., Holm N.R., Lindsay M., Spence M.S., Erglis A., Menown I.B. et al. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): A prospective, randomised, open-label, non-inferiority trial. Lancet. 2016;388(10061):2743–2752. DOI: 10.1016/S0140-6736(16)32052-9.Mäkikallio T., Holm N.R., Lindsay M., Spence M.S., Erglis A., Menown I.B. et al. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): A prospective, randomised, open-label, non-inferiority trial. Lancet. 2016;388(10061):2743–2752. DOI: 10.1016/S0140-6736(16)32052-9.Wang J., Guan C., Chen J., Dou K., Tang Y., Yang W. et al. Validation of bifurcation DEFINITION criteria and comparison of stenting strategies in true left main bifurcation lesions. Sci. Rep. 2020;10(1):10461. DOI: 10.1038/s41598-020-67369-9.Wang J., Guan C., Chen J., Dou K., Tang Y., Yang W. et al. Validation of bifurcation DEFINITION criteria and comparison of stenting strategies in true left main bifurcation lesions. Sci. Rep. 2020;10(1):10461. DOI: 10.1038/s41598-020-67369-9.Katritsis D.G., Siontis G.C.M., Ioannidis J.P.A. Double versus single stenting for coronary bifurcation lesions: A meta-analysis. Circ. Cardiovasc. Interv. 2009;2(5):409–415. DOI: 10.1161/CIRCINTERVENTIONS.109.868091.Katritsis D.G., Siontis G.C.M., Ioannidis J.P.A. Double versus single stenting for coronary bifurcation lesions: A meta-analysis. Circ. Cardiovasc. Interv. 2009;2(5):409–415. DOI: 10.1161/CIRCINTERVENTIONS.109.868091.Nasir M., Shafique H.M., Hussain S., Tuyyab F., Aziz S., Khadim R. Percutaneous сoronary intervention for left main coronary artery bifurcation lesions: Two-stent versus one-stent strategy for comparison of 6-month MACE. J. Coll. Physicians Surg. Pak. 2020;30(9):894–899. DOI: 10.29271/jcpsp.2020.09.894.Nasir M., Shafique H.M., Hussain S., Tuyyab F., Aziz S., Khadim R. Percutaneous сoronary intervention for left main coronary artery bifurcation lesions: Two-stent versus one-stent strategy for comparison of 6-month MACE. J. Coll. Physicians Surg. Pak. 2020;30(9):894–899. DOI: 10.29271/jcpsp.2020.09.894.Chen S.L., Zhang J.J., Han Y., Kan J., Chen L., Qiu C. et al. Double kissing crush versus provisional stenting for left main distal bifurcation lesions: DKCRUSH-V Randomized Trial. J. Am. Coll. Cardiol. 2017;70(21):2605–2617. DOI: 10.1016/j.jacc.2017.09.1066.Chen S.L., Zhang J.J., Han Y., Kan J., Chen L., Qiu C. et al. Double kissing crush versus provisional stenting for left main distal bifurcation lesions: DKCRUSH-V Randomized Trial. J. Am. Coll. Cardiol. 2017;70(21):2605–2617. DOI: 10.1016/j.jacc.2017.09.1066.Kandzari D.E., Gershlick A.H., Serruys P.W., Leon M.B., Morice M.C., Simonton C.A. et al. Outcomes among patients undergoing distal left main percutaneous coronary intervention. Circ. Cardiovasc. Interv. 2018;11(10):e007007. DOI: 10.1161/CIRCINTERVENTIONS.118.007007.Kandzari D.E., Gershlick A.H., Serruys P.W., Leon M.B., Morice M.C., Simonton C.A. et al. Outcomes among patients undergoing distal left main percutaneous coronary intervention. Circ. Cardiovasc. Interv. 2018;11(10):e007007. DOI: 10.1161/CIRCINTERVENTIONS.118.007007.Российское кардиологическое общество (РКО). Стабильная ишемическая болезнь сердца. Клинические рекомендации 2020. Российский кардиологический журнал. 2020;25(11):4076. DOI: 10.15829/1560-4071-2020-4076.Russian Society of Cardiology (RSC). 2020 Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2020;25(11):4076. (In Russ). DOI: 10.15829/1560-4071-2020-4076.Knuuti J., Wijns W., Saraste A., Capodanno D., Barbato E., Funck-Brentano C. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur. Heart J. 2020;41(3):407–477. DOI: 10.1093/eurheartj/ehz425.Knuuti J., Wijns W., Saraste A., Capodanno D., Barbato E., Funck-Brentano C. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur. Heart J. 2020;41(3):407–477. DOI: 10.1093/eurheartj/ehz425.Hildick-Smith D., de Belder A.J., Cooter N., Curzen N.P., Clayton T.C., Oldroyd K.G. et al. Randomized trial of simple versus complex drug-eluting stenting for bifurcation lesions. The British Bifurcation Coronary Study: Old, new, and evolving strategies. Circulation. 2010;121(10):1235–1243. DOI: 10.1161/CIRCULATIONAHA.109.88829.Hildick-Smith D., de Belder A.J., Cooter N., Curzen N.P., Clayton T.C., Oldroyd K.G. et al. Randomized trial of simple versus complex drug-eluting stenting for bifurcation lesions. The British Bifurcation Coronary Study: Old, new, and evolving strategies. Circulation. 2010;121(10):1235–1243. DOI: 10.1161/CIRCULATIONAHA.109.88829.Chen X., Li X., Zhang J.J., Han Y., Kan J., Chen L. et al. 3-year outcomes of the DKCRUSH-V Trial Comparing DK crush with provision al stenting for left main bifurcation lesions. JACC Cardiovasc. Interv. 2019;12(19):1927–1937. DOI: 10.1016/j.jcin.2019.04.056.Chen X., Li X., Zhang J.J., Han Y., Kan J., Chen L. et al. 3-year outcomes of the DKCRUSH-V Trial Comparing DK crush with provisional stenting for left main bifurcation lesions. JACC Cardiovasc. Interv. 2019;12(19):1927–1937. DOI: 10.1016/j.jcin.2019.04.056.Hildick-Smith D., Egred M., Banning A., Brunel P., Ferenc M., Hovasse T. et al. The european bifurcation club Left Main Coronary Stent study: A randomized comparison of stepwise provisional vs. systematic dual stenting strategies (EBC MAIN). Eur. Heart J. 2021;42(37):3829–3839. DOI: 10.1093/eurheartj/ehab283.Hildick-Smith D., Egred M., Banning A., Brunel P., Ferenc M., Hovasse T. et al. The European bifurcation club Left Main Coronary Stent study: A randomized comparison of stepwise provisional vs. systematic dual stenting strategies (EBC MAIN). Eur. Heart J. 2021;42(37):3829–3839. DOI: 10.1093/eurheartj/ehab283.Takagi K., Nagoshi R., Kim B.K., Kim W., Kinoshita Y., Shite J. et al. Efficacy of coronary imaging on bifurcation intervention. Cardiovasc. Interv. Ther. 2021;36(1):54–66. DOI: 10.1007/s12928-020-00701-2.Takagi K., Nagoshi R., Kim B.K., Kim W., Kinoshita Y., Shite J. et al. Efficacy of coronary imaging on bifurcation intervention. Cardiovasc. Interv. Ther. 2021;36(1):54–66. DOI: 10.1007/s12928-020-00701-2.Kim J.S., Hong M.K., Ko Y.G., Choi D., Yoon J.H., Choi S.H. et al. Impact of intravascular ultrasound guidance on long-term clinical outcomes in patients treated with drug-eluting stent for bifurcation lesions: Data from a Korean multicenter bifurcation registry. Am. Heart J. 2011;161(1):180– 187. DOI: 10.1016/j.ahj.2010.10.002.Kim J.S., Hong M.K., Ko Y.G., Choi D., Yoon J.H., Choi S.H. et al. Impact of intravascular ultrasound guidance on long-term clinical outcomes in patients treated with drug-eluting stent for bifurcation lesions: Data from a Korean multicenter bifurcation registry. Am. Heart J. 2011;161(1):180– 187. DOI: 10.1016/j.ahj.2010.10.002.Neumann F.J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U. et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019;40(2):87–165. DOI: 10.1093/eurheartj/ehy394.Neumann F.J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U. et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019;40(2):87–165. DOI: 10.1093/eurheartj/ehy394.Murasato Y., Mori T., Okamura T., Nagoshi R., Fujimura T., Yamawaki M. et al. Efficacy of the proximal optimization technique on crossover stenting in coronary bifurcation lesions in the 3D-OCT bifurcation registry. Int. J. Cardiovasc. Imaging. 2019;35(6):981–990. DOI: 10.1007/s10554-019-01581-1.Murasato Y., Mori T., Okamura T., Nagoshi R., Fujimura T., Yamawaki M. et al. Efficacy of the proximal optimization technique on crossover stenting in coronary bifurcation lesions in the 3D-OCT bifurcation registry. Int. J. Cardiovasc. Imaging. 2019;35(6):981–990. DOI: 10.1007/s10554-019-01581-1.

The authors declare that there are no conflicts of interest present.