Mini-Culotte and Double-Kissing (DK) Mini-Culotte Stenting

Dr. Ahmet Kıvrak

Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Türkiye

ABSTRACT

The chapter explores the background and importance of culotte stenting in coronary interventions, particu- larly for complex bifurcation lesions. While culotte stenting has shown favorable outcomes, studies like DK- CRUSH-III trial have highlighted its limitations, leading to the development of innovative techniques like mini culotte and DK-mini culotte. These techniques offer simplified procedures while retaining the benefits of traditional culotte stenting.

It provides an overview of mini culotte and DK-mini culotte techniques, emphasizing their procedural steps, outcomes, and advancements. Mini culotte, pioneered by Wen SY et al., addresses challenges of bifurca- tion lesions with improved stent placement. The guide outlines the steps involved, including vascular access, pre-dilation, stent placement, and kissing balloon inflation, with attention to challenges like stent alignment and balloon selection.

Similarly, DK-mini culotte is explored as an advanced technique, offering reduced metal coverage and en- hanced side branch access. Its step-by-step guide covers vascular access, pre-dilatation, stent placement, and kissing balloon inflation, with considerations for challenges specific to this technique. Both techniques align closely with contemporary guidelines for bifurcation lesion interventions.

In conclusion, mini culotte and DK-mini culotte techniques offer simplified procedures with improved out- comes, emphasizing the need for advanced technical skills and meticulous attention to detail for successful results and patient safety.

Keywords: Coronary bifurcation lesions; Mini culotte; DK-mini culotte; Coronary interventions

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