The Impact of Pre And Post Dilatation on Stent Deformity After Kissing Balloon Technique in a Large Left Main Bifurcation Model

Abstract

The Impact of Pre And Post Dilatation on Stent Deformity After Kissing Balloon Technique in a Large Left Main Bifurcation Model. Soichiro Enomoto, Tomoaki Ito, Takenori Domei, Kisaki Amemiya, Hiroyoshi Yokoi, Masashi Iwabuchi, Masakiyo Nobuyoshi. Kokura Memorial Hospital, Kitakyusyu, Japan. Background: Treating left main (LM) bifurcation with stents is complex as LM trunks have larger vessel references than others. Kissing balloon technique (KBT) and/or post stent dilatation to LM trunks are needed in order to obtain adequate stent apposition in LM trunks. The objective of this study was to investigate the impact of pre and post left main dilatation on stent deformity during KBT. Methods: LM bifurcation vessel model with 6.0mm proximal vessel reference was used in this study. After crossover stenting (3.5mm Nobori stent, Terumo Corporation, Tokyo) to the main branch, two strategies of LM dilatation with a 6.0mm balloon were tested. Strategy in model A was LM dilatation after KBT and not before, while strategy in model B was LM dilatation before and not after KBT. Results: In model A, post LM dilatation after KBT led to decrease the effect of KBT; stent malaposition in the ostial of the side branch. On the other hand, in model B, adequate stent apposition in the ostial of the side branch was obtained by KBT without any unfavorable major distortion in the main or LM trunk. Conclusion: LM dilatation before performing KBT is better especially when KBT is performed in large LM bifurcation lesions. If LM dilatation after KBT is needed, checking of stent distortion should be done afterward.