A Systematic Review of Jailed Balloon Technique for Coronary Bifurcation Lesion: Conventional-Jailed Balloon Technique vs Modified-Jailed Balloon Technique

Abstract

BackgroundIn this systematic review, we aim to evaluate the latest evidence on the efficacy and safety of conventional jailed balloon technique and modified jailed balloon technique for bifurcation lesion, and also whether the former or latter is more effective for preventing side branch occlusion during main branch stenting in bifurcation lesions. MethodsWe performed comprehensive search on studies assessing the efficacy and safety of conventional jailed balloon and modified jailed balloon technique for bifurcation lesion from several electronic databases. ResultsThere were 908 patients from six studies comprising of 615 in conventional jailed balloon technique group and 293 in modified jailed balloon technique group. Side branch loss was lower in modified jailed balloon technique group, however, the proportion of lesions with TIMI flow <3 in the final percutaneous coronary intervention result was somewhat higher in the modified jailed balloon technique group. The efficacy issue regarding side branch dissection was reported as high as 3.4%, especially at proximal stent edge in conventional jailed balloon technique group, but not quantitatively described in the modified jailed balloon technique group. Zero percent major adverse cardiovascular events at 9–12 months follow up was demonstrated in modified jailed balloon technique group, and 1–5% in the conventional jailed balloon group at a longer observation period up to 2.7 years. ConclusionOur study showed that modified jailed balloon technique is potentially better compared to conventional jailed balloon in terms of side branch loss, dissection, and major adverse cardiovascular events. Further controlled studies are warranted for definite conclusion.