Kompleks Koroner Bifurkasyon Lezyonlarında Double Kissing Crush Stentleme Tekniği: Genç Anterior Miyokard İnfarktüsü Olgusu
Özet
Akut miyokard enfarktüsü sırasında sorumlu lezyonun koroner bifurkasyon bölgesinde yer alması, girişimsel tedavisinin seçimi açısından teknik güçlükler barındırmaktadır. Bu olgu sunumunda, akut anterolateral ST-segment yükselmeli miyokard enfarktüsü ile başvuran 41 yaş erkek hastada görülen Medina 1,1,1 paterninde LAD-diagonal bifurkasyon lezyonunun perkütan tedavisi sunulmaktadır. Hastanın kliniği ve lezyonun anatomik özellikleri nedeniyle planlı çift stent yaklaşımı tercih edilip ve DK-crush tekniği uygulandı. Bu olguda DK-crush tekniğinin uygulanması basamak basamak anlatıldı. İşlem sonunda her iki damarda başarılı revaskülarizasyon sağlanıp, hasta komplikasyonsuz bir klinik seyir sonrasında taburcu edildi. Bu vaka üzerinde, akut koroner sendrom zeminindeki kompleks bifurkasyon lezyonlarında DK-crush tekniğinin uygulanabilirliği ve güncel literatürdeki yeri değerlendirilmiştir.
The presence of the culprit lesion within a coronary bifurcation during acute myocardial infarction poses significant technical challenges in the selection and execution of interventional treatment strategies. In this case report, we present the percutaneous treatment of a Medina 1,1,1 LAD–diagonal bifurcation lesion in a 41-year-old male patient who presented with acute anterolateral ST-segment elevation myocardial infarction. Given the patient's clinical presentation and the anatomical characteristics of the lesion, a planned two-stent strategy was selected, and the DK-crush technique was performed. The procedural steps of the DK-crush technique are described in detail. Successful revascularization of both vessels was achieved, and the patient was discharged following an uncomplicated clinical course. This case highlights the feasibility of the DK-crush technique in the management of complex bifurcation lesions in the setting of acute coronary syndrome and reviews its role in the contemporary literature.
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