Three-dimensional optical frequency domain imaging of a true bifurcation lesion after stent implantation using the jailed semi-inflated balloon technique

Numasawa, Yohei; Hase, Hiromu; Yamazaki, Hiroyuki; Tabei, Ryota; Kuno, Toshiki; Kodaira, Masaki; Saito, Tetsuya

doi:10.1177/2050313x17724711

Cited by 5 publications

(6 citation statements)

References 14 publications

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“…It impacts less on the bifurcation segment by means of limiting carina and plaque shift towards to SB, which are two major factors responsible for SB compromise [18]. Yohei Numasawa [17] evaluated the configuration of true bifurcation lesion after stent implantation using the jailed balloon technique by three-dimensional optical frequency domain imaging (OFDI) which provided clearer and higher resolution images. It was already indicated clearly that there were no signs of plaque or carina shift into the SB.…”

Section: Discussionmentioning

confidence: 99%

“…Major SB occlusion after MV stenting is one of the most serious complications closely associated with cardiac death and MI, and it may be the major reason why operators prefer more aggressive strategy in the bifurcation lesions [12–15]. Therefore, to prevent from carina displacement—the basic mechanism of side branch compromise during bifurcation percutaneous coronary intervention, several novel stenting systems for bifurcation lesions have been developed [16, 17].…”

Section: Introductionmentioning

confidence: 99%

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Modified balloon-stent kissing technique avoid side-branch compromise for simple true bifurcation lesions

Zhang

Liu

et al. 2019

BMC Cardiovasc Disord

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Background Coronary bifurcation remains one of the most challenging lesion subsets in interventinal cardiology. Provisional stenting (PS) is the dominate technique for bifurcation lesions, but the key problem is the deterioration of side branch. Balloon-stent kissing technique (BSKT) as a new systematic approach which is based on modified jailed balloon technique is applied to improve the procedure success. In our center, we proposed a modified balloon-stent kissing technique(M-BSKT), which routine usage of proximal optimizing technique (POT) after rewiring was added as an optimization step to BSKT. Thus, whether M-BSKT for addressing simple true coronary bifurcation lesions can provide more benefits in intra-operation effect and long term outcomes is still unknown. Methods A cohort of 120 consecutive patients underwent Percutaneous Coronary Intervention (PCI) with simple true coronary bifurcation lesions satisfied the criteria were included in this retrospective, single-center registry. To assemble a cohort with similar baseline characteristics, a 1:1 propensity-matched score was used. The primary outcomes were the rate of device and procedural success, the situation of side branch (SB) after main vessel (MV) inflation and the complications during intra-operative. The secondary outcomes were the clinical prognosis at 12 months such as rehospitalization for unstable angina and MACEs. Results Before propensity matching, there were no significant differences in primary and secondary outcomes between two groups. After propensity-matched was used, 68 patients with similar propensity scores were included. At immediate procedural, M-BSKT was associated with a lower risk of SB deterioration and the application of final kissing balloon inflation (FKBI)[ P = 0.036]. For ACS patients, besides the significant differences of immediate SB deterioration [ P = 0.014] and FKBI application [ P = 0.033], the incidence of TIMI flow< 3 in the PS was statistically significant higher than M-BSKT [ P = 0.042]. The prognosis at 12 months such as rehospitalization for unstable angina and MACEs were similar for two groups [ P = 0.613]. Conclusion These observations prove that the M-BSKT enables side branch to be better protected in simple true bifurcation lesions, by a narrow margin. It may improve the angiographic outcomes about side branch deterioration and final kissing balloon performing compared with PS, especially in ACS patients. However, long-term clinical outcomes did not differ between patients treated for M-BSKT and PS at 12 months.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Modified balloon-stent kissing technique avoid side-branch compromise for simple true bifurcation lesions

Zhang

Liu

et al. 2019

BMC Cardiovasc Disord

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“…To overcome difficulties associated with PCI for bifurcation lesions, the jailed balloon technique and jailed Corsair technique have been established [ 3 – 9 ]. The jailed semi-inflated balloon technique provides a high rate of procedural success and preservation of the side branch blood flow after main vessel stenting mainly because it prevents carina or plaque shift [ 5 , 8 ]. However, this technique is associated with potential risks including jailed balloon entrapment, balloon rupture, and dissection of the side branch ostium by balloon inflation even with low pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, this technique cannot be performed via the radial artery. Second, because the proximal marker of the side branch balloon should be located more proximal to the stent edge to prevent entrapment [ 6 , 8 ], a long balloon with double radiopaque markers is necessary. Finally, the use of a semi-inflated balloon or Corsair microcatheter for side branch protection is off-label, and it may also be associated with an increase in the total procedural cost.…”

Section: Discussionmentioning

confidence: 99%

A Novel Double Side Branch Protection Technique for a Left Main Trifurcation Lesion: Simultaneous Jailed Balloon and Jailed Corsair Technique

Munakata

Numasawa

Ishikawa

et al. 2018

Case Reports in Cardiology

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Percutaneous coronary intervention for left main trifurcation disease is challenging. Although side branch protection techniques such as the jailed balloon technique and jailed Corsair technique are the established methods for treatment of coronary bifurcation lesions, little is known regarding the application and feasibility of these techniques for left main trifurcation disease. We herein describe a 72-year-old man with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a left main trifurcation lesion. In this case, we performed a novel double side branch protection technique, the simultaneous jailed balloon and jailed Corsair technique, with a single 8 Fr guiding catheter. This is the first case report to highlight the feasibility and efficacy of combined use of the jailed balloon and jailed Corsair techniques during percutaneous coronary intervention for left main trifurcation disease.

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“…Every patient received anticoagulation using heparin during the procedure with targeted ACT of 300″, while use of glycoprotein IIb/IIIa inhibitors were left to the operator's discretion. The procedure of JSIBT for CABD is described in detail elsewhere [11, 12]. The steps of JSIBT applied to our patients are shown in Figure 1 (JSIBT with DES) and Figure 2 (JSIBT with BVS).…”

Section: Methodsmentioning

confidence: 99%

Acute Angiographic and Intermediate-Term Clinical Results of Patients with Non-Left Main Coronary Bifurcation Lesions Treated with BVS by Jailed Semi-Inflated Balloon Technique and Provisional Side-Branch Stenting Strategy

Chang

Lai

et al. 2019

Journal of Interventional Cardiology

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Background To evaluate the acute angiographic and intermediate-term clinical results of patients with non-left main (LM) coronary artery bifurcation disease (CABD) treated with BVS, as compared with those treated with DES, using the jailed semi-inflated balloon technique (JSIBT) for side branch (SB) protection and provisional stenting. Methods and Results Sixty-eight patients with non-LM CABD who had undergone provisional one-stent implantation with SB protection by JSIBT between January 2015 and December 2017 were retrospectively enrolled. Among them, 20 patients received Absorb BVS implantation and 48 patients received DES implantation. Patients in the BVS group were younger and had higher BMI, total cholesterol, low-density lipoprotein cholesterol, and hemoglobin but had lower serum creatinine and lower prevalence of prior PCI and MI. No SB balloon rupture/entrapment occurred in either group. The incidence of SB dissection/occlusion and SB in need of rewiring or stenting was rare in both groups and showed no significant difference between them. Postinterventional TIMI flow significantly increased in both groups. The intermediate-term clinical outcomes were good in terms of incidence of target lesion failure, target lesion revascularization, target vessel revascularization, myocardial infarction, and all-cause death in both groups. Conclusion The use of JSIBT for treating CABD with modern BVS can provide SB protection as similar as those with DES, even with higher incidence of acute SB dissection/occlusion. The immediate angiographic results and acute and intermediate-term clinical outcomes were also similar in both groups. Our study results demonstrate that JSIBT might be a safe and alternative SB protection tool for BVS in patients with complex CABD.

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Three-dimensional optical frequency domain imaging of a true bifurcation lesion after stent implantation using the jailed semi-inflated balloon technique

Cited by 5 publications

References 14 publications

Modified balloon-stent kissing technique avoid side-branch compromise for simple true bifurcation lesions

Modified balloon-stent kissing technique avoid side-branch compromise for simple true bifurcation lesions

A Novel Double Side Branch Protection Technique for a Left Main Trifurcation Lesion: Simultaneous Jailed Balloon and Jailed Corsair Technique

Acute Angiographic and Intermediate-Term Clinical Results of Patients with Non-Left Main Coronary Bifurcation Lesions Treated with BVS by Jailed Semi-Inflated Balloon Technique and Provisional Side-Branch Stenting Strategy

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