Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent

Grundeken, Maik J.; Lesiak, Maciej; Asgedom, Solomon; Garcı́a, Eulogio; Bethencourt, Armando; Norell, Michael S.; Damman, Peter; Koch, Karel T.; Vis, Marije M.; Henriques, José P.S.; Tijssen, Jan G.P.; Onuma, Yoshinobu; Foley, David P.; Bartorelli, Antonio L.; Stella, Pieter R.; Winter, Robbert J. de; Wykrzykowska, Joanna J.

doi:10.1136/heartjnl-2013-304912

Cited by 14 publications

(9 citation statements)

References 23 publications

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“…These results are in agreement with our previous clinical trial, POLBOS I, in which application of FKB and POT was associated with lower LLL and better clinical outcomes [ 4 ]. These findings were confirmed in other studies, also in trials with other dedicated bifurcation stents [ 18 – 20 ].…”

Section: Discussionsupporting

confidence: 86%

12-month intravascular ultrasound observations from BiOSS® first-in-man studies

Gil

Bil

Costa

et al. 2016

Int J Cardiovasc Imaging

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The aim of this study was to analyze the difference in neointima pattern assessed by intravascular ultrasound (IVUS) between two dedicated bifurcation stents, BiOSS® Expert and BiOSS® LIM at 12-month follow-up. This manuscript reports IVUS findings obtained from the analysis of patients enrolled into first-in-man registries initially assessing the BiOSS Expert® (paclitaxel) and BiOSS LIM® (sirolimus) stents. Quantitative angiographic analysis was performed pre, post-stenting, and at follow-up. IVUS examination was performed at 12 months. There were analyzed 34 cases (BiOSS Expert® 11 patients, BiOSS LIM® 23 patients). Procedural characteristics in the two groups were similar, except for rates of main vessel predilatation and FKB/POT, which were higher in BiOSS® LIM group, 54.5 % vs 73.9 % (P < 0.05) and 0 % vs 39.1 % (P < 0.05), respectively. When comparing late lumen loss (LLL) for both stents there were significantly bigger values for main vessel and main branch in the BiOSS® Expert group, but not in side branch. Intravascular ultrasound examination showed that in the BiOSS LIM® group comparing with the BiOSS Expert® group there was lower neointima burden in the whole stent (24.7 ± 7.5 % vs 19.4 ± 8.6 %, P < 0.05) as well as in main vessel (22.8 ± 5.6 % vs 16.9 ± 6.1 %, P < 0.05) and main branch (36.1 ± 6.5 % vs 27.6 ± 8.7 %, P < 0.05), but not at the level of bifurcation (15.1 ± 3.8 % vs 13.6 ± 5.4 %, P = NS). In addition, we found that final kissing balloon/proximal optimization technique (FKB/POT) was associated with significantly smaller value of LLL in main vessel (0.24 ± 0.09 mm vs 0.32 ± 0.14 mm, P < 0.05), which in IVUS analysis resulted in smaller neointima burden in main vessel (13.7 ± 3.9 % vs 18.9 ± 4.45 %, P < 0.05) as well as at the bifurcation site (12.6 ± 4.1 % vs 14.1 ± 2.4 %, P < 0.05). The obtained results suggest that neointima proliferation was the largest in main branches of both stents assessed in quantitative angiography (LLL) as well as in IVUS (neointima burden) and the neointima increase was smaller in BiOSS LIM® stents than in BiOSS Expert® stents. Moreover, the middle part of the stent seems to not to be associated with excessive neointima proliferation and more aggressive protocol of implantation with the use FKB/POT seems to decrease this process.Electronic supplementary materialThe online version of this article (doi:10.1007/s10554-016-0926-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

12-month intravascular ultrasound observations from BiOSS® first-in-man studies

Gil

Bil

Costa

et al. 2016

Int J Cardiovasc Imaging

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“…The administration of statin was related to dyslipidaemia and stent length was related to lesion length. Several factors influence the kissing balloon technique technique, including operator’s proficiency, CKD, ST segment elevation myocardial infarction as an indication for PCI, a narrow bifurcation angle and stent platforms 17 . Therefore, we excluded statin administration, stent length and kissing balloon technique from the multivariate analysis.…”

Section: Resultsmentioning

confidence: 99%

Relationship between left coronary artery bifurcation angle and restenosis after stenting of the proximal left anterior descending artery

Konishi

Yamamoto

Funayama

et al. 2016

Coronary Artery Disease

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“…The effect of BA on final kissing balloon inflation (FKBI) remained a question to be clarified. Grundeken et al reported that narrow angle B was significantly associated with FKBI failure. However, Chen et al and Dzavik et al found that angle B did not necessarily affect the performance of FKBI.…”

Section: Introductionmentioning

confidence: 99%

Coronary Bifurcation Intervention: What Role Do Bifurcation Angles Play?

Zhang

Dou

2015

J Interven Cardiology

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Bifurcation angles play an important role in coronary bifurcation intervention. Bifurcation angles affect the coronary bifurcation intervention from many aspects: (1) impact the atherosclerosis proliferation via affecting the hemodynamic parameters at bifurcation regions; (2) impact side branch compromise after main vessel stenting via hemodynamics, atherosclerosis proliferation, geometric characteristics, and plaque/carina shift; (3) affect the long-term clinical outcome after coronary bifurcation stenting. Bifurcation angles are key factors to formulate the intervention strategy of stenting procedure and can also be modified by different bifurcation stenting strategies. In the last few years, significant improvements have occurred in understanding the role of bifurcation angles. However, there are still questions remain to be clarified: (1) How to measure the bifurcation angles accurately and comprehensively? (2) How do bifurcation angles impact the immediate and long term outcome of PCI? (3) Why the results of previous studies remain controversial? The exact influence of bifurcation angles on post-PCI effect like side branch compromise and clinical outcome has not been fully elucidated. In this review, we highlight the current knowledge of bifurcation angles, summarize the questions remained to be clarified, and discuss the implications for clinical practice and future studies.

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Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent

Cited by 14 publications

References 23 publications

12-month intravascular ultrasound observations from BiOSS® first-in-man studies

12-month intravascular ultrasound observations from BiOSS® first-in-man studies

Relationship between left coronary artery bifurcation angle and restenosis after stenting of the proximal left anterior descending artery

Coronary Bifurcation Intervention: What Role Do Bifurcation Angles Play?

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