DK Crush in Unprotected LMS

Abstract

Introduction: This case report highlights a novel approach in the management of refractory angina by utilizing advanced interventional techniques for Chronic Total Occlusion (CTO) lesions. While conventional interventional cardiology tends to avoid treating CTO due to potential complications, this case presents the modern crush techniques, such as Double Kissing (DK) Crush.

Case Presentation: The patient under study presented with refractory angina, a condition characterized by persistent chest pain despite medical treatment. The focus was on a CTO lesion, which traditionally poses high risks and often necessitates surgical intervention. However, in this instance, the patient's condition and suitable anatomical characteristics made them a candidate for an alternative approach.

Results: The management involved the use of advanced CTO equipment and endovascular methods, deviating from the conventional surgical route. The chosen Percutaneous Coronary Intervention (PCI) approach proved successful, resulting in the complete resolution of the CTO lesion. This intervention led to a notable improvement in the patient's overall cardiac function, both regionally and globally, as evidenced by follow-up assessments.

Conclusion: This case underscores the potential of advanced CTO PCI techniques in managing refractory angina patients with appropriate anatomical features. The modern crush techniques, such as DK-Crush, are providing excellent results on mid and long-term follow up, suggesting that it’s a good way to obtain surgical-like outcomes in the treatment of complex LM bifurcation disease.