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Final kissing balloon inflation for coronary bifurcation lesions treated with single-stent technique :
1Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Insights
Final kissing balloon (FKB) inflation in one-stent strategies for bifurcation lesions does not significantly reduce major adverse cardiac events (MACE). A selective FKB approach may be more appropriate for these complex coronary interventions.
Area of Science:
- Interventional Cardiology
- Cardiovascular Research
- Medical Device Technology
Background:
- The clinical benefit of final kissing balloon (FKB) inflation in one-stent techniques for coronary artery bifurcation lesions remains debated.
- This study evaluates the impact of FKB on long-term clinical outcomes within one-stent strategies.
Purpose of the Study:
- To determine if final kissing balloon (FKB) inflation improves long-term clinical outcomes in patients undergoing one-stent treatment for bifurcation lesions.
- To analyze the effect of FKB on major adverse cardiac events (MACE) in this patient population.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Embase, and Cochrane Library databases up to August 2017.
- Major adverse cardiac events (MACE), defined as cardiac death, myocardial infarction, or target lesion revascularization, were the primary outcome.
- Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a random-effects model.
Main Results:
- Ten studies involving 7364 patients treated with a one-stent technique were analyzed.
- FKB did not significantly reduce MACE compared to non-FKB in both randomized trials (HR: 1.13; 95% CI: 0.65-1.98) and observational studies (HR: 0.86; 95% CI: 0.61-1.20).
- Similar risks were observed for cardiac death, myocardial infarction, and target lesion revascularization between FKB and non-FKB groups.
Conclusions:
- Final kissing balloon (FKB) inflation may not be a mandatory component of one-stent strategies for bifurcation lesions.
- A selective application of FKB may offer a more justified approach, optimizing patient care and resource utilization.
Background:
The efficacy of final kissing balloon (FKB) inflation in one-stent techniques for bifurcation lesions is controversial. The goal of the present study was to investigate the impact of FKB on long-term clinical outcomes in one-stent strategies.
Methods:
A literature search of the PubMed, Embase, and Cochrane Library databases was undertaken through August 2017. The primary outcome was major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction, and target lesion revascularization. Overall hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model.
Results:
Ten studies comprising 7364 patients treated with a one-stent technique were included in the analysis. Overall, FKB did not demonstrate a significant reduction in MACE compared with non-FKB in both randomized trials (HR: 1.13; 95% CI: 0.65-1.98) and observational studies (HR: 0.86; 95% CI: 0.61-1.20). The risk of cardiac death (HR: 0.89; 95% CI: 0.53-1.49), myocardial infarction (HR: 0.76; 95% CI: 0.53-1.09), and target lesion revascularization (HR: 0.96; 95% CI: 0.74-1.23) was also similar in both groups.
Conclusion:
FKB may not be mandatory and a selective FKB strategy might be more justified in one-stent techniques for bifurcation lesions.
