Abstract
BackgroundPercutaneous coronary interventions (PCI) of bifurcation lesions is technically challenging and associated with lower success rates and higher frequency of adverse outcomes. In the present study, we aimed to evaluate the immediate and long-term treatment effect and adverse events of a new modified jailed-balloon technique on side branch (SB) during PCI on coronary bifurcation lesions.MethodsThis was a prospective study of 60 patients (49 males, 11 females, mean age 66 ± 10 years) with coronary bifurcation lesions treated at the Beijing Hospital between September 2014 and October 2015. They underwent main vessel (MV) stenting and modified jailed-balloon technique on the SB. All patients were followed with hospital visits at 9 months. Angiographic success, major adverse cardiac events (MACE), SB occlusion, and angina were evaluated.ResultsThe majority of the patients had acute coronary syndrome (91.7%) and Medina 1.1.1. bifurcation lesions (71.7%). After MV stenting, thrombolysis in myocardial infarction (TIMI) 3 flow was established 100% of MV and 93.3% of SB. No SB occlusion occurred. The jailed SB balloon and wire could be successfully removed in all patients without damage or entrapment. The majority (91.7%) of patients achieved Canadian Cardiovascular Society I stage. There was no MACE during in-hospital stay and 9-month follow-up.ConclusionThe modified JBT provided high rate of procedural success, excellent SB protection during MV stenting, and excellent immediate and long-term clinical outcomes.
Highlights
Acute coronary syndromes (ACS) refer to a spectrum of acute myocardial ischemia and/or necrosis usually secondary to reduction in coronary blood flow and include unstable angina, non-ST-elevation myocardial infarction, and ST-elevation myocardial infarction [1, 2]
Angiographic success was defined as successful implantation of the stent into the main vessel (MV) and final residual stenosis ≥30% without MV and side branch (SB) flow impairment [19]
Clinical events were defined based on the recommendations of the Academic Research Consortium [23]
Summary
Acute coronary syndromes (ACS) refer to a spectrum of acute myocardial ischemia and/or necrosis usually secondary to reduction in coronary blood flow and include unstable angina, non-ST-elevation myocardial infarction, and ST-elevation myocardial infarction [1, 2]. Artery bifurcations are prone to develop atherosclerosis lesions because of the high shear stress and endothelial erosion from the turbulent blood flow [8, 9]. 15 to 20% of percutaneous coronary interventions (PCI) are performed to treat coronary bifurcation lesions [10, 11]. PCI of bifurcation lesions is technically challenging and associated with lower. Percutaneous coronary interventions (PCI) of bifurcation lesions is technically challenging and associated with lower success rates and higher frequency of adverse outcomes. We aimed to evaluate the immediate and long-term treatment effect and adverse events of a new modified jailed-balloon technique on side branch (SB) during PCI on coronary bifurcation lesions
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