Impact of guidewire recrossing point into stent jailed side branch for optimal kissing balloon dilatation: core lab 3D optical coherence tomography analysis

Abstract

The guidewire recrossing point and the location of a stent link at the SB orifice had an influence on the ISA. KBD with optimal conditions under 3D-OCT guidance may reduce SB restenosis.

Prognostic impact of final kissing balloon technique after crossover stenting for the left main coronary artery: from the AOI-LMCA registry

“…FKBT has been widely performed at any bifurcation on the expectations of optimizing stent apposition at the main branch, ameliorating the side branch ostial narrowing caused by carina shift, reducing strut protrusion into the side branch ostium, and maintaining access to the side branch [ 16 ]. In contrast, FKBT might be associated with injury of the side branch ostium potentially leading to restenosis, stent deformation related to over-dilation of the stent proximal to the side branch, and strut mal-apposition due to inadequate rewiring position [ 17 , 18 ]. FKBT is generally advocated after a two-stent strategy for any bifurcation [ 19 , 20 ].…”

“…One of the reasons for these neutral results might be that FKBT was not harmful despite its potential risks, because the frequency of IVUS use was higher than in previous reports [ 9 – 12 ]. Guidance with IVUS or OCT is useful particularly for the LMCA for confirming side branch distal rewiring before FKBT and determination of stent and balloon sizes [ 18 , 24 ]. However, FKBT often needs a higher volume of contrast, longer procedure time, and more devices than no FKBT [ 9 , 12 ].…”

Confirmation of jailed side-branch ostium in coronary bifurcation intervention by stent-oriented three-dimensional intravascular ultrasound

“…Using the stent-oriented 3D-IVUS, the jailing type and rewiring position on the jailed SBO could be confirmed as a link-connecting type and proximal rewiring (Fig. 1E) [1][2][3].…”

“…The confirmation of jailing type and rewiring position on the side-branch ostium (SBO) by the three-dimensional (3D) optical coherence tomography (OCT)/optical frequency domain imaging (OFDI) is reported to lead to good stent apposition in percutaneous coronary intervention (PCI) for bifurcation lesion [1][2][3].…”

Comparison of diagnostic performance in assessing the rewiring position into a jailed side branch between online 3D reconstruction systems version 1.1 and 1.2 derived from optical frequency domain imaging

“…In an assessment of the rewiring position by the offline 3D reconstruction system, high feasibility and good inter- and intra-observer agreements have been reported [ 4 ]. In contrast, the diagnostic performance of the online 3D-OCT/OFDI reconstruction systems has been unclear.…”