Abstract
In simple bifurcation lesions provisional single stent strategy remains the standard of care. While complex bifurcations, defined based on the 1) Side Branch (SB) lesion length of > 10 mm and 2) SB ostial diameter stenosis of >70% are approached with a 2-DES strategy upfront. The Crush techniques which are composed of the classic Crush, mini-Crush and double kissing Crush (DK-Crush) share the core principle of protruding the SB DES within the Main Branch (MB) to minimize the risk of ostial SB restenosis, which remains the most prevalent etiology of stent failure during 2-stent approach in bifurcations. Proximal SB optimization (PSO) is an additional technical consideration to further optimize the protruding SB struts enabling 1) optimal SB strut accommodation to the larger MB vessel diameter, 2) strut enlargement that will further facilitate effortless rewiring for kissing balloon inflation (KBI) avoiding unfavorable guide wire advancement in the peri-ostial SB area.
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