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Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance Meta-Analysis of Comparison of 5-Year Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Unprotected Left Main Coronary Artery in the Era of Drug-eluting Stents Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II Positive remodeling at 3 year follow up is associated with plaque-free coronary wall segment at baseline: a serial IVUS study Management of left main disease: an update Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Left Main Coronary Artery Stenosis: A Systematic Review and Meta-analysis Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main and Multivessel Coronary Artery Disease: Do We Have the Evidence? Long-term outcome of prosthesis-patient mismatch after transcatheter aortic valve replacement Usefulness of intravascular ultrasound to predict outcomes in short-length lesions treated with drug-eluting stents

Original Research2018 Oct 1;19(10):1117-1125.

JOURNAL:Eur Heart J Cardiovasc Imaging. Article Link

Serial changes in the side-branch ostial area after main-vessel stenting with kissing balloon inflation for coronary bifurcation lesions, assessed by 3D optical coherence tomography

Fujimura T, Okamura T, Tateishi H et al. Keywords: 3D optical coherence tomography; KBI; side-branch ostium

ABSTRACT

AIMS - We evaluated the influence of the jailing configuration and guidewire rewiring position in front of the side-branch(SB) ostium before kissing balloon inflation (KBI) against side-branch ostial area (SBOA) at follow-up using 3D optical coherence tomography (3D-OCT).


METHODS AND RESULTS - We retrospectively analysed the cases of the 37 consecutive patients who underwent main-vessel (MV) stenting with KBI for coronary bifurcation lesion under OCT guidance and the follow-up OCT 6-12 months. We divided the patients into two groups, considering both the jailing configuration and the rewiring position by 3D-OCT. We defined the cases that achieved both the distal rewiring and link-free carina configuration as the FCD group, and the other cases were defined as the Non-FCD group. We compared the differences in the SBOA derived by the cut-plane analysis and the number of compartments between the two groups. The median and interquartile range of serial change and percent serial change in SBOA in the FCD group were significantly larger than those in the Non-FCD group [0.43 mm2 (-0.29 to 0.91) vs. -0.65 mm2 (-1.33 to 0.34); P = 0.0136 and 9.47% (-8.37 to 27.33) vs. -13.77% (-31.64 to 10.88); P = 0.0182].


CONCLUSION - This serial OCT study demonstrated that the achievement of both the distal rewiring and link-free carina configuration may be important for the preservation of the SBOA after MV stenting with KBI for coronary bifurcation lesions.