Potential Benefit of Final Kissing Balloon Inflation After Single Stenting for the Treatment of Bifurcation Lesions - Insights From Optical Coherence Tomography Observations

作者：Hariki Hirotoshi; Shinke Toshiro^*; Otake Hiromasa; Shite Junya; Nakagawa Masayuki; Inoue Takumi; Osue Tsuyoshi; Iwasaki Masamichi; Taniguchi Yu; Nishio Ryo; Hiranuma Noritoshi; Kinutani Hiroto; Konishi Akihide; Hirata Ken ichi

来源：Circulation Journal, 2013, 77(5): 1193-1201.

DOI：10.1253/circj.CJ-12-0848

• Coronary artery disease
• Drug-eluting stent
• Optical coherence tomography
• Thrombus

Background: Treatment of coronary bifurcation lesions using a single stenting strategy is preferable over that using a 2-stent technique. The benefit of final kissing inflation (FKI), however, has not been established. %26lt;br%26gt;Methods and Results: Seventy-two patients (76 lesions) with true bifurcation lesions treated with a single drug-eluting stent with FKI (n=33 lesions) or without FKI (non-FKI, n=43 lesions) were enrolled in this study. Optical coherence tomography (OCT) was performed at 6-12 months after implantation. Based on the OCT findings, the percentage of jailing struts (number of jailing struts/total number of struts at the bifurcation lesion) was calculated. Percentage of uncovered struts and frequency of thrombus attachment were each evaluated at the proximal, bifurcation, and distal segments. Major adverse cardiac events (MACE) were also evaluated. The percentage of jailing struts was significantly lower in the FKI than in the non-FKI group (5.8+/-6.2% vs. 17.3+/-6.1%, P%26lt;0.01). Thrombus attachment was less frequent in the FKI group (24.2% vs. 46.5%, P=0.046), especially at side-branch orifices (3.0% vs. 27.9%, P%26lt;0.001). The percentage of uncovered struts was lower in the FKI than non-FKI group at the proximal, bifurcation, and distal segments. The incidence of MACE was not different in this small cohort. %26lt;br%26gt;Conclusions: FKI might reduce the frequency of subclinical thrombus possibly by reducing the number of jailing struts. (Circ J 2013; 77: 1193-1201)

• 出版日期2013-5