A Short Term Clinical Outcome of Provisional versus Routine Kissing Balloon Technique after Main Vessel Crossover Stenting for Coronary Bifurcation Lesions
Mohamed Ahmed Khalil *
Cardiovascular Medicine Department, Faculty of Medicine, Tanta University, Egypt.
Fatehia Ahmed Elsheshtawy
Cardiovascular Medicine Department, Faculty of Medicine, Tanta University, Egypt.
Medhat Mohamed Ashmawy
Cardiovascular Medicine Department, Faculty of Medicine, Tanta University, Egypt.
Samiah Mahmoud Sharaf El-Din
Cardiovascular Medicine Department, Faculty of Medicine, Tanta University, Egypt.
Ayman Mohamed Elsaeed
Cardiovascular Medicine Department, Faculty of Medicine, Tanta University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Kissing Balloon Inflation (KBI) technique was the first technique for percutaneous intervention in bifurcation lesions. It's the standard strategy in the two-stent procedure. Its benefit in one-stent approach remains uncertain. Several trials comparing KBI strategy with the No-KBI strategy in one-stent technique did not show any advantages in the clinical outcome. Clinical outcome and the follow up of ischemic symptoms is a useful method to compare the effectiveness of both strategies.
Aims: To study the short-term clinical outcome (3and 6 months) of provisional versus routine kissing‑balloon technique after main vessel stenting for coronary bifurcation lesions.
Patients and Methods: The study included sixty consecutive patients. They were randomized to receive different side branch (SB) intervention strategies: group I (provisional final kissing balloon inflation group - PFKBI) (FKBI only when SB Flow less than TIMI 3) and group II (routine final kissing balloon inflation group – RFKBI).
Results: 1- Dissection of side branch and conversion to two stent strategy was significantly higher in PFKBI group (14,3%) than in RFKBI group (0) 2-The amount of dye, total procedure time and time of admission was significantly higher in RFKBI group. 3-Chest pain immediately after the procedure was significantly higher in PFKBI group while at 3 and 6 months follow up no significant difference between both groups was noticed. 4- MACE, target lesion revascularization (TLR) and stent thrombosis were similar between both groups at 3 and 6 months.
Conclusions: Main vessel stenting with and without final kissing balloon dilatation was associated with favorable and similar 3 and 6-month clinical outcomes.
Keywords: Routine kissing balloon technique, main vessel crossover stenting, coronary bifurcation lesions.