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Bifurcation Stenting

Abstract

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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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