A Short Term Clinical Outcome of Provisional versus Routine Kissing Balloon Technique after Main Vessel Crossover Stenting for Coronary Bifurcation Lesions

Abstract

Background: Kissing Balloon Inflation (KBI) technique was the first technique for percutaneous intervention in bifurcation lesions. It's the standard strategy in the two-stent procedure. Its benefit in one-stent approach remains uncertain. Several trials comparing KBI strategy with the No-KBI strategy in one-stent technique did not show any advantages in the clinical outcome. Clinical outcome and the follow up of ischemic symptoms is a useful method to compare the effectiveness of both strategies. Aims: To study the short-term clinical outcome (3and 6 months) of provisional versus routine kissing‑balloon technique after main vessel stenting for coronary bifurcation lesions. Patients and Methods: The study included sixty consecutive patients. They were randomized to receive different side branch (SB) intervention strategies: group I (provisional final kissing balloon inflation group - PFKBI) (FKBI only when SB Flow less than TIMI 3) and group II (routine final kissing balloon inflation group – RFKBI). Results: 1- Dissection of side branch and conversion to two stent strategy was significantly higher in PFKBI group (14,3%) than in RFKBI group (0) 2-The amount of dye, total procedure time and time of admission was significantly higher in RFKBI group. 3-Chest pain immediately after the procedure was significantly higher in PFKBI group while at 3 and 6 months follow up no significant difference between both groups was noticed. 4- MACE, target lesion revascularization (TLR) and stent thrombosis were similar between both groups at 3 and 6 months. Conclusions: Main vessel stenting with and without final kissing balloon dilatation was associated with favorable and similar 3 and 6-month clinical outcomes.