Modified jailed balloon technique for bifurcation lesions.

Area of Science:

• Interventional Cardiology
• Cardiovascular Surgery
• Medical Devices

Background:

• Bifurcation stenting is complex, with a significant risk of side branch (SB) occlusion (over 7.0%).
• SB occlusion is a serious complication during percutaneous coronary intervention (PCI) of bifurcations.

Purpose of the Study:

• To introduce and evaluate the clinical efficacy of a novel modified jailed balloon technique (M-JBT) for bifurcation stenting.
• To assess the safety and effectiveness of M-JBT in preserving SB patency.

Main Methods:

• The M-JBT involves placing a jailed balloon (JB) in the SB (half the main branch stent size) before MB stent deployment.
• Simultaneous inflation of the MB stent and JB, followed by JB removal and optional kissing balloon dilatation (KBD) or TAP stenting.
• Bench testing was performed to compare MB stent deformation with conventional jailed balloon techniques.

Main Results:

• The study included 233 patients with 254 bifurcation lesions, including 54 left main trunk cases.
• 100% procedural success was achieved with M-JBT, with no instances of SB occlusion observed.
• KBD was performed in 183 lesions, TAP stenting in 31, and bench tests showed reduced MB stent deformity compared to conventional JBT.

Conclusions:

• The modified jailed balloon technique (M-JBT) represents the first clinical experience with this novel approach.
• M-JBT is a safe and effective method for bifurcation stenting, successfully preserving SB patency.
• This technique offers a promising alternative for managing complex coronary bifurcations.