Clinical outcomes following percutaneous coronary intervention for bifurcation lesions: kissing balloon inflation vs....

Area of Science:

• Interventional Cardiology
• Cardiovascular Research
• Medical Device Technology

Background:

• Percutaneous coronary intervention (PCI) for coronary artery bifurcation lesions presents unique challenges.
• The necessity and impact of adjunctive techniques like kissing balloon inflation (KBI) remain subjects of debate.

Purpose of the Study:

• To compare clinical outcomes between single crossover stent implantation with KBI versus sequential dilation alone for non-left main bifurcation lesions.
• To evaluate the impact of KBI on target lesion revascularization (TLR) rates in this patient cohort.

Main Methods:

• Retrospective analysis of 255 non-left main bifurcation lesions in 246 patients treated with single crossover stenting.
• Lesions were divided into two groups: KBI (n=74) and sequential dilation (n=181).
• Primary endpoint was target lesion revascularization (TLR) at a median follow-up of approximately 3 years.

Main Results:

• No significant differences in pre-procedural vessel diameters between groups.
• The KBI group had smaller main vessel post-dilation balloon size, lower pressure, and a significantly smaller post-procedural minimal lumen diameter.
• TLR incidence was significantly higher in the KBI group (especially in the distal main vessel) compared to the sequential dilation group.

Conclusions:

• Single crossover stenting with KBI for bifurcation lesions is associated with a higher TLR rate than sequential dilation.
• Suboptimal stent expansion in the main vessel, potentially due to smaller balloon size and lower pressure during KBI, may contribute to increased revascularization events.