Abstract
Provisional side-branch T stenting (PTS) has emerged as a gold standard in the treatment of bifurcation lesions. Final kissing balloon inflation (Kiss) allows optimisation of main branch (MB) stent deployment and SB ostium scaffolding with the MB stent. By improving proximal MB stent deployment and avoiding overstretch of the SB, non compliant balloons (NC) may improve these results. to assess in a pilot study, the angiographic results and clinical outcome after bifurcation lesion stenting using NC balloons (Hiryu, Terumo) for Kiss. The default strategy was systematic use of 2 wires in 6 Fr guiding catheters, no SB predilatation, MB stenting using Sirolimus, Everolimus or Paclitaxel drug eluting stents followed by provisional SB stenting using 6 Fr. Pts with Medina 0,0,1 lesions, in-stent restenosis or left main disease were excluded. 100 bifurcation lesions were treated in 98 Pts. They were 67 ± 11 y-o, 78% male, 22% diabetics. Indication for PCI was silent ischemia in 23%, stable angina 47% and acute coronary syndrome 30%. Transradial approach was used in 87% of cases. Lesions were mainly located in LAD-diagonal bifurcation (50%). Reference MB diameter was 3.18 ± 0.55 mm and SB 2.28 ± 0.40 mm. MB lesion length was 16.3 ± 6.6 mm and SB 2.34 + 2.18 mm. The MB was predilated in 49% of cases and SB in 0%. MB stent length was 22.7 ± 6.9 mm and diameter 3.10 ± 0.36 mm. Kiss was performed in all cases but in 3 SB dilatation through the MB stent with a small balloon was needed before Kiss. Optimal SB scaffolding by the MB stent was observed by “stent boost” in 89% of cases. In the remaining, SB dissection or residual lesion > 70% was observed and a SB stent was needed in 7 cases (7%). In hospital outcome was uneventful. Treatment of bifurcation lesions with PTS approach using NC balloons is feasible with excellent immediate results and a low need for SB stenting. Six-month clinical outcome will be presented at the meeting.
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