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Bifurcation Stenting

Abstract

Recommended Article

Three-Year Outcomes of the DKCRUSH-V Trial Comparing DK Crush With Provisional Stenting for Left Main Bifurcation Lesions Double kissing crush in left main coronary bifurcation lesions: A crushing blow to the rival stenting techniques Classic crush and DK crush stenting techniques Contemporary techniques in percutaneous coronary intervention for bifurcation lesions Impact of the complexity of bifurcation lesions treated with drug-eluting stents: the DEFINITION study (Definitions and impact of complEx biFurcation lesIons on clinical outcomes after percutaNeous coronary IntervenTIOn using drug-eluting steNts) Optimal Fluoroscopic Projections of Coronary Ostia and Bifurcations Defined by Computed Tomographic Coronary Angiography Treatment effects of systematic two-stent and provisional stenting techniques in patients with complex coronary bifurcation lesions: rationale and design of a prospective, randomised and multicentre DEFINITION II trial Culotte stenting vs. TAP stenting for treatment of de-novo coronary bifurcation lesions with the need for side-branch stenting: the Bifurcations Bad Krozingen (BBK) II angiographic trial
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Original Research2020 Jul 14;EIJ-D-20-00334.

JOURNAL：Eurointervention. Article Link

Feasibility and efficacy of the ultrashort side branch dedicated balloon in coronary bifurcation stenting

Y Murasato, M Nishihara, T Mori et al. Keywords: kissing balloon inflation vs. glider balloon; stent configuration; high-angled bifurcation; coronary bifurcation stenting

ABSTRACT

AIMS - We sought to investigate the feasibility and efficacy of the Glider balloon (GB), a side branch (SB) dedicated balloon 4-mm in length, in coronary bifurcation stenting.

METHODS AND RESULTS - In bifurcation bench models, stent configuration was examined with micro-focus computed tomography after crossover stenting followed by GB dilation or kissing balloon inflation (KBI). GB dilation maintained cross-sectional stent area without significant deformation and presented effective jailed strut removal in a high-angled bifurcation model.


We performed GB dilatation after main vessel (MV) stenting for 207 lesions in 194 patients, which included left main, true-bifurcation lesion, and two-stent treatment in 42.0%, 45.9%, and 14.0%, respectively. Proximal optimization technique (POT) or POT-like inflation was performed in 82.1%. GB crossing failure, SB stenting due to dissection, and stent deformation requiring correction by KBI or MV dilation occurred in 8.7, 1.4, and 5.8%, respectively. Finally, simple GB dilation without KBI had been completed in 91.8% for SB dilation. At 1-year follow-up, target lesion revascularization, cardiac death, myocardial infarction, and stent thrombosis were found in 7.2%, 2.1%, 2.1%, and 1.0%, respectively.


CONCLUSION - Simple GB dilation after adequate expansion of proximal MV stent provided acceptable acute and long-term results as an alternative to KBI.

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