Final kissing ballooning and long-term clinical outcomes in coronary bifurcation lesions treated with 1-stent technique: results from the COBIS registry

Gwon, Hyeon Cheol; Hahn, Joo Yong; Koo, Bon Kwon; Song, Young Bin; Choi, Seung Hyuk; Choi, Jin Ho; Lee, Sang Hoon; Jeong, Jin‐Ok; Kim, Hyo Soo; Seong, In Whan; Yang, Ju Young; Rha, Seung Woon; Jang, Yangsoo; Yoon, Jung Han; Tahk, Seung Jea; Seung, Ki Bae; Park, Seung Jung

doi:10.1136/heartjnl-2011-300322

Cited by 103 publications

(69 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Variables previously reported to influence TLR or MACE were also entered into the multivariate model, such as diabetes mellitus, 14 chronic kidney disease (CKD), 15 2 stent technique to both MV and SB, 16 and FKB. 6 The following patient level candidate predictors were evaluated in step-wise variable selection: age, being male, current smoking, hyperlipidemia, hypertension, chronic heart failure, dialysis, presence of peripheral artery disease, unstable angina, prior PCI, prior myocardial infarction, lesion in the left anterior descending artery (LAD), whether an emergency procedure was performed, in-stent restenosis, multiple stents (≥2 stents per lesion), MV post-MLD, IVUS usage, stent maximum deployment pressure, Figure 2B). Long-term dual antiplatelet therapy use was similar between the FKB-and no-FKB groups as well as between the no-FKB and the singlestent-use groups ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…Biprovisional approach. 6 Randomized controlled trials (RCT) such as THUEBIS and the Nordic-Baltic bifurcation Study-III did not demonstrate any clinical benefit of SB balloon angioplasty followed by MV stenting. 8, 9 However, the follow-up duration of these RCTs were only 6 months, and the lack of long-term follow up fails to convincingly identify the merit of FKB in the 1-stent approach.…”

Section: Study Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Clinical Outcome of a Single Stent Approach With and Without a Final Kissing Balloon Technique for Coronary Bifurcation

Yamawaki

Muramatsu

Kozuma

et al. 2014

Circ J

View full text Add to dashboard Cite

110YAMAWAKI M et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp oronary bifurcation has been regarded as one of the most challenging lesion subsets due to poor clinical outcomes compared with non-bifurcated lesions. 1 Provisional intervention of the side branch (SB) after main vessel (MV) stenting is now the standard approach for most bifurcations. 2,3 Although the final kissing balloon technique (FKB) has been established as the first-line strategy for bifurcations treated with an elective 2-stent approach, 4,5 its efficacy in a 1-stent approach is presently under debate. 6,7 Randomized trials showed no benefit of FKB in a 1-stent approach; 8,9 however, the long-term clinical outcome remains unclear as limited data is currently available. 6,10 The purpose of the present study is to: (1) investigate the long-term outcomes after a 1-stent approach with and without FKB; and (2) to ascertain the clinical outcome after cross-over stenting without FKB in comparison with non-bifurcation patients. MethodsThis study is a sub-analysis of the TAXUS Japan Postmarket Surveillance Study (TAXUS-PMS), which evaluated the safety and performance of a paclitaxel-eluting stent (PES; TAXUS

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

Long-Term Clinical Outcome of a Single Stent Approach With and Without a Final Kissing Balloon Technique for Coronary Bifurcation

Yamawaki

Muramatsu

Kozuma

et al. 2014

Circ J

View full text Add to dashboard Cite

show abstract

“…The recently published results from the COBIS II Korean registry were in strikingly contradictory to previously published results from the same group in an earlier report from the COBIS I registry [26,27]. In COBIS I, patients, after kissing balloon inflation (KBI), performed worse regarding patients with no KBI despite higher TLR rates, while in the COBIS II registry the reverse was true -patients after final KBI had better results, with less in-stent restenosis.…”

Section: What Do the Data Currently Demonstrate About Bifurcationmentioning

confidence: 59%

“…We and others [28,40,42] have demonstrated that the most important mechanism of SB stenosis occurrence is displacement of the bifurcation carina tip from stent struts in the direction of the SB ostium. The carina displacement is the leading mechanism of SB closure, but additional plaque shifting from the main vessel or plaque redistribution of SB ostium per se is necessary to close the vessel completely [27,40,42]. However, even without closure, the branch could be stenosed enough to cause ischaemia.…”

Section: Side-branch Compromise and Periprocedural Myonecrosis: How Mmentioning

confidence: 99%

Is it possible to further improve clinical results with coronary bifurcation stenting, or what is more important — the technique or the stent?

2017

View full text Add to dashboard Cite

“…This was addressed in a large observational study of 1055 patients undergoing bifurcation stenting. 64 A comparative propensity analysis of patients who did and did not have final kissing balloon inflations showed a higher incidence of MACE and target lesion revascularisation, mostly in the main vessel, for patients who had final kissing balloon inflations. The pendulum therefore has now swung away from final kissing balloon inflation, which may cause more harm than good.…”

Section: Bifurcation Stentingmentioning

confidence: 99%

Almanac 2012: Interventional cardiology

Meier

2013

Revista Portuguesa de Cardiologia (English Edition)

View full text Add to dashboard Cite

The field of interventional cardiology continues to progress quickly. The efficacy of percutaneous interventions with newer generation drug-eluting stents has advanced a lot over the last decade. This improvement in stent performance has broadened the level of indication towards more complex interventions such as left main and multivessel PCI. Major improvements continue in the field of medical co-therapy such as antiplatelet therapies (bivalirudin, prasugrel, ticagrelor) and this will further improve outcomes of PCI. The same is true for intravascular imaging such as ultrasound IVUS and optical coherence tomography OCT. However, interventional cardiology has become a rather broad field, also including alcohol septal ablation for hypertrophic obstructive cardiomyopathy, etc. At the moment, the fastest growing area is the structural interventions, especially for aortic valve stenosis (transcatheter aortic valve implantation TAVI) and for mitral regurgitation (mitral clipping). This review covers recent advances in all these different fields of interventional cardiology. PERCUTANEOUS CORONARY INTERVENTION VERSUS MEDICAL TREATMENTPercutaneous coronary intervention (PCI) has guideline recommendations for treatment of ST elevation and non-ST elevation myocardial infarction (MI). 1 However, its role in stable coronary disease has been the subject of reappraisal following publication of the COURAGE trial, which showed that, in patients receiving optimal medical therapy, PCI does not improve cardiovascular outcomes, while incremental benefits for quality of life disappear by 36 months. A more recent meta-analysis of eight trials of optimal medical therapy versus PCI involving 7229 patients bears out the COURAGE conclusions by showing no significant differences between the groups with regard to death (9.1% vs 8.9%), non-fatal MI (8.1% vs 8.9%), unplanned revascularisation (30.7% vs 21.4%) and persistent angina (33% vs 29%).4 Drug-eluting stents (DESs) were used in only a minority of these patients and may have reduced the need for further revascularisation while improving symptomatic responses. Nevertheless, the meta-analysis reinforces contemporary guideline advice for optimal medical treatment as the initial treatment for stable angina.

show abstract

Final kissing ballooning and long-term clinical outcomes in coronary bifurcation lesions treated with 1-stent technique: results from the COBIS registry

Abstract: clinicaltrials.gov number: NCT00851526.

Cited by 103 publications

References 20 publications

Long-Term Clinical Outcome of a Single Stent Approach With and Without a Final Kissing Balloon Technique for Coronary Bifurcation

Long-Term Clinical Outcome of a Single Stent Approach With and Without a Final Kissing Balloon Technique for Coronary Bifurcation

Is it possible to further improve clinical results with coronary bifurcation stenting, or what is more important — the technique or the stent?

Almanac 2012: Interventional cardiology

Contact Info

Product

Resources

About