DK Crush

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Figure 9 from Circulation 2004;109:1244-9.

The "double kiss crush" bifurcation technique was first described by Colombo and colleagues in 2004.[1]


  1. Pre-dilate the main branch (MB) and side branch (SB) if necessary.
  2. Position a balloon in the MB with the distal tip at the level of the carina.
  3. Stent the SB with 1-2 mm protrusion in the main vessel (MV).
  4. Remove the wire and stent balloon from the SB.
  5. Crush the SB stent with the MB balloon.
  6. Wire the crushed SB stent proximally.
  7. Dilate SB stent struts.
  8. First kissing balloon inflation (KBI).
  9. Remove SB balloon and wire.
  10. Stent the MV.
  11. First proximal optimisation technique (POT).
  12. SB recrossing.
  13. Final KBI.
  14. Final POT.


  1. Circulation 2004;109:1244-9.
  2. J Am Coll Cardiol Intv 2016;9:1861–78).