Key result
Balloon-stent kissing technique cuts side-branch occlusion ~100% vs jailed wire technique in coronary bifurcation lesions.
Why the study?
Side-branch occlusion is a serious complication of provisional one-stent strategies used to treat coronary bifurcation lesions, prompting a comparison of clinical outcomes between the balloon-stent kissing technique and jailed wire technique.
Does the balloon-stent kissing technique improve clinical and angiographic outcomes compared to the jailed wire technique in patients undergoing PCI for coronary bifurcation lesions?
RCT (n=89)
Double-blind
Sequentially numbered, opaque, sealed envelopes
No
Does the balloon-stent kissing technique improve clinical and angiographic outcomes compared to the jailed wire technique in patients undergoing PCI for coronary bifurcation lesions?
Absolute Event Rate: 0% vs 15.6%
p-value: p=0.018
The balloon-stent kissing technique significantly reduces side-branch occlusion and perioperative MACEs compared to the jailed wire technique in patients undergoing PCI for true coronary bifurcation lesions.
Supports balloon-stent kissing in bifurcation PCI to minimize occlusion and MACE; confirms superiority versus jailed wire in this RCT.
Side-branch occlusion is a serious complication of provisional one-stent strategies used to treat coronary bifurcation lesions. The aim of the study was to compare the short- and long-term clinical outcomes between the balloon-stent kissing technique (BSKT) and jailed wire technique (JWT) in patients with non-left coronary bifurcation lesions.This prospective, double-blinded, randomized controlled study enrolled 89 consecutive patients (aged 18-85 years) with 90 true bifurcation lesions (hemadostenosis ≥70%; bifurcation angle <90°; Medina classification 1.1.1, 1.0.1, or 0.1.1) who underwent percutaneous coronary intervention (PCI) at the Zhongshan Hospital Affiliated to Dalian University (China) between January 2013 and May 2016. The patients were randomly divided into the BSKT (44 patients, 45 lesions) and JWT (45 patients, 45 lesions) groups. The intervention was conducted according to technical requirements using a single-stent strategy. Operative success rate, occurrence of complications, postoperative quantitative coronary angiography, and incidence of perioperative and long-term major adverse cardiovascular events (MACEs) were compared between groups.The intervention success rate was 100% in both groups. After main-branch stenting, the BSKT was associated with significantly lower rates of side-branch occlusion (0% vs 15.6%, P < .05) and side-branch post-processing (8.9% vs 26.7%, P < .05) than the JWT. The BSKT was associated with significantly lower degrees of postoperative proximal main-branch residual stenosis (6.1 ± 5.1% vs 9.6 ± 8.6%, P < .05) and side-branch ostial stenosis (51.6 ± 20.6% vs 70.3 ± 20.8%, P < .05) than the JWT. The incidence of perioperative MACEs was significantly lower in the BSKT group than in the JWT group (0% vs 13.3%, P < .05). Patients were followed for a mean duration of 19.0 ± 6.1 months. The occurrence rates of long-term MACEs, angina of Canadian Cardiovascular Society grade ≥2, and severe heart failure were not significantly different between groups.The BSKT is a safe and effective technique that may have advantages over the JWT with regard to protection of the side-branch during PCI for bifurcation lesions.
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Jin et al. (2019) conducted an RCT in Non-left coronary bifurcation lesions (n=89). Balloon-stent kissing technique vs. Jailed wire technique was evaluated on Side-branch occlusion (p=0.018). The balloon-stent kissing technique significantly reduced the rate of side-branch occlusion to 0% compared to 15.6% with the jailed wire technique in patients with coronary bifurcation lesions.
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