Case 25: PCI Manual: Reverse Crush

We describe the reverse crush (also known as internal crush) technique for treating the side branch of a coronary bifurcation if main vessel stenting compromises the origin of the side branch (which can be assessd by FFR or iFR). The side branch is rewired through the main vessel stent and predilated. A balloon is placed in the main vessel across the origin of the side branch. A stent is placed into the side branch protruding at least 2-3 mm into the main vessel and deployed. The stent balloon is removed and the main vessel balloon is inflated crushing the side branch stent struts protruding into the main vessel. The side branch is rewired through a proximal strut and final kissing balloon inflation is performed.