Protective ballooning technique for prevention of side branch occlusion in coronary nonleft main true bifurcation lesions: A single‐center study

Abstract

Objectives We aimed to evaluate the efficacy of a protective ballooning technique in preventing side branch (SB) occlusion and to assess the long‐term clinical outcomes for coronary nonleft main true bifurcation lesions. Background SB occlusion is a major complication associated with percutaneous coronary intervention (PCI) for coronary bifurcation lesions. Methods Patients were consecutively enrolled and randomly assigned to protective ballooning technique or jailed wire technique group. Periprocedural and long‐term clinical outcomes were compared. Results Patients in the protective ballooning technique (n = 173) and jailed wire technique (n = 167) groups were followed up for 12 months. SB occlusion occurred in one patient (0.6%) and nine patients (5.4%) in each group, respectively. The proportion of thrombolysis in myocardial infarction (TIMI) flow grade 3 of the SB was higher in the protective ballooning technique group (98.8% vs. 95.2%, p < 0.05). SB rewiring was necessary in one patient in the protective ballooning technique group (0.6%) with provisional stenting, significantly lower than that in the jailed wire technique group (seven patients, 4.2%; p = 0.03). Periprocedural myocardial infarction occurred in three (1.73%) and six (3.59%) patients in the protective ballooning technique and jailed wire technique groups without significant difference, respectively. Major adverse cardiovascular events at 12 months were similar in both groups. Conclusions Protective ballooning technique is effective for the prevention of SB occlusion in nonleft main true bifurcation lesions and had favorable long‐term outcomes at the 12‐month follow‐up.

Comparison of Jailed Wire and Jailed Balloon for Prevention of Side Branch Occlusion in Provisional Stenting: Evidence from a Systematic Review and Meta-Analysis

“…Two were added by reviewing the relevant references. Finally, 13 studies involving 1789 patients were enrolled, including four published in English and nine published in Chinese [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. The flowchart for identifying these studies is shown in Fig.…”

“…The baseline information of the enrolled studies and participants is displayed in Tables 1A , 1B , 2 (Ref. [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]). There are nine RCTs and four observational studies.…”

“…SB occlusion was reported in ten studies [ 6 , 7 , 8 , 10 , 11 , 12 , 14 , 16 , 17 , 18 ]. was 0.00, indicating that the heterogeneity of these studies was small.…”

A early-onset case of post-cardiac injury syndrome after coronary stenting

“…After the main branch and branch pre-expansion, a Bingo drug-eluting balloon of 2.5 mm×15.0 mm was administered at the D1 opening lesion. Under the protective ballooning technique, [8] a Resolute Integrity 2.5 mm×18.0 mm stent was implanted in the LAD lesion with acceptable residual stenosis of the D1 opening. A Resolute Integrity 2.25 mm×30.00 mm stent was implanted in the RAM lesion (Figure 1).…”