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Sequential vs. kissing balloon angioplasty for stenting of bifurcation coronary lesions
Author(s) -
Brueck Martin,
Scheinert Dierk,
Flachskampf Frank A.,
Daniel Werner G.,
Ludwig Josef
Publication year - 2002
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10100
Subject(s) - medicine , angioplasty , balloon , cardiology , coronary stenting , cutting balloon , stent , radiology , restenosis
Coronary angioplasty of bifurcation lesions remains a technical challenge and is believed to result in low procedural success associated with the risk of side‐branch occlusion. Furthermore, long‐term results are associated with a high rate of reintervention. The aim of the study was to evaluate the immediate and long‐term clinical and angiographic results of sequential vs. simultaneous balloon angioplasty (kissing balloon technique) for stenting of bifurcation coronary lesions. Between December 1999 and January 2001, 59 patients underwent coronary angioplasty because of symptomatic bifurcation lesions type III (i.e., side branch originates from within the target lesion of the main vessel, and both main and side branch are angiographically narrowed more than 50%). Twenty‐six patients were treated with simultaneous and 33 patients with sequential balloon angioplasty. Main‐vessel stent placement was mandatory; side‐branch stenting and platelet IIb/IIIa antagonists were allowed at the discretion of the operator. Kissing balloon technique offered no advantage in terms of procedural success or need for repeat target vessel revascularization due to restenosis at 6‐month follow‐up. Using sequential balloon angioplasty, permanent or transient side‐branch compromise rate (TIMI flow < 3) was significantly higher than after kissing balloon technique (33% vs. 0%, respectively; P = 0.003). Major clinical events in‐hospital or at 6‐month follow‐up, however, showed no significant differences. Kissing balloon angioplasty reduces the rate of transient side‐branch occlusion compared to sequential PTCA but does not improve immediate or long‐term outcome compared to sequential PTCA for stenting of bifurcation lesions. Cathet Cardiovasc Intervent 2002;55:461–466. © 2002 Wiley‐Liss, Inc.