Key result
Jailed balloon technique was superior to jailed wire technique in reducing side branch occlusion (9.1% vs. 19.9%, p=0.02) in patients with high-risk bifurcation lesions.
Why the study?
The jailed balloon technique is considered superior to the jailed wire technique for reducing side branch occlusion, but randomized trial evidence was lacking.
Does the jailed balloon technique reduce side branch occlusion compared to the jailed wire technique in patients with high-risk coronary bifurcation lesions?
RCT (n=284)
randomly assigned
Yes
Does the jailed balloon technique reduce side branch occlusion compared to the jailed wire technique in patients with high-risk coronary bifurcation lesions?
Absolute Event Rate: 9.1% vs 19.9%
p-value: p=0.02
In patients with high-risk coronary bifurcation lesions, the jailed balloon technique significantly reduces side branch occlusion compared to the jailed wire technique, though 1-year MACE rates are similar.
JBT reduces SB occlusion versus conventional strategy in high-risk bifurcations; supports first-line use over jailed wire in such lesions.
Objective Jailed balloon technique (JBT) is an active side branch (SB) protection strategy and is considered to be superior to the jailed wire technique (JWT) in reducing SB occlusion. However, no randomized trials have proved that. We aim to investigate whether JBT could decrease the SB occlusion rate. Methods Conventional versus Intentional straTegy in patients with high Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion (CIT-RESOLVE) (NCT02644434, registered on December 31, 2015) ( https://clinicaltrials.gov ) is a randomized trial that assessed the effects of different strategies on SB occlusion rate in patients with a high risk of SB occlusion. The present subgroup analysis enrolled bifurcation lesions (2 mm ≤ reference vessel diameter of SB < 2.5 mm) with Visual estimation for Risk prEdiction of Side branch OccLusion in coronary bifurcation intervention (V-RESOLVE) score ≥ 12 points. The primary endpoint is SB occlusion. One-year clinical events were compared. Results A total of 284 subjects at 16 sites were randomly assigned to the JBT group ( n = 143) or the JWT group ( n = 141). The rate of SB occlusion (9.1 vs. 19.9%, p = 0.02) and periprocedural myocardial infarction (defined by WHO, 7 vs. 14.9%, p = 0.03) is significantly lower in the JBT group than in the JWT group. The JBT and JWT groups showed no significant differences in cardiac death (0.7 vs. 0.7%, p = 1), myocardial infarction (MI, 6.3 vs. 7.1%, p = 0.79), target lesion revascularization (TLR, 1.4 vs. 2.1%, p = 0.68), and major cardiac adverse events (MACE, a composite of all-cause death, MI, or TLR, 8.4 vs. 10.6%, p = 0.52) during a 1-year follow-up. Conclusion In patients with a high risk of SB occlusion (V-RESOLVE score ≥ 12 points), JBT is superior to JWT in reducing SB occlusion. However, no significant differences were detected in 1-year MACE.
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Zhang et al. (2022) conducted an RCT in Coronary bifurcation lesions with high risk of side branch occlusion (n=284). Jailed balloon technique (JBT) vs. Jailed wire technique (JWT) was evaluated on Side branch (SB) occlusion (p=0.02). Jailed balloon technique was superior to jailed wire technique in reducing side branch occlusion (9.1% vs. 19.9%, p=0.02) in patients with high-risk bifurcation lesions.
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