Classic crush and DK crush stenting techniques.

Clinical data have supported the advantages of the double kissing (DK) crush technique, which consists of stenting the side branch (SB), balloon crush, first kissing, stenting the main vessel (MV) and final kissing balloon inflation, for complex coronary bifurcation lesions compared to other stenting techniques. Careful rewiring from the proximal cell of the MV stent to make sure the wire is in the true lumen of the SB stent is key to acquiring optimal angiographic results. Balloon anchoring from the MV, alternative inflation and each kissing inflation using large enough non-compliant balloons at high pressure, and the proximal optimisation technique are mandatory to improve both angiographic and clinical outcomes. Stratification of a given bifurcation lesion is recommended before decision making.