| Summary: | QUESTION: What aspects do you think might explain the significant differences reported between the results from the EBC MAIN (European bifurcation club left main coronary stent study),1 and the DKCRUSH-V (Double kissing crush vs provisional stenting for left main distal bifurcation lesions) clinical trials?2 ANSWER: Both studies differ in several aspects we could categorized into 4: those that are operator-related; study design-related; patient and lesion-related, and those associated with the results from the provisional stenting technique. The double kissing (DK) is a complex technique where most of the evidence available in the medical literature (including the DKCRUSH-V2) comes from the same group of expert operators who have been using such technique for years now.3,4 However, the operators from the EBC MAIN1 belong to the European Bifurcation Club that has spent years promoting and refining the provisional stenting technique. Regarding the study design, the group of patients randomized to 2 different stents is also different from one trial to the other: in the DKCRUSH-V only patients treated with the DK crush technique were while in the EBC MAIN most patients were treated with the culotte technique or the T stenting technique. Another different aspect between both trials is the use of systematic angiographic assessments...
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