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Comparison of failure rates of crossing side branch with pressure vs. coronary guidewire: a meta‐analysis
Author(s) -
Ather Sameer,
Bavishi Chirag P.,
Bhatia Vikas,
Bajaj Navkaranbir S.,
Leesar Massoud A.
Publication year - 2016
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12620
Subject(s) - medicine , fractional flow reserve , cardiology , percutaneous coronary intervention , balloon , heart failure , coronary angiography , myocardial infarction
Objectives The aim of this study was to compare the failure rates of crossing side branch ( SB ) with pressure guidewire vs. coronary guidewire after main vessel ( MV ) stenting in coronary bifurcation lesions ( CBL ). Background Percutaneous coronary intervention of CBL is technically difficult. The European Bifurcation Club recommends performing either fractional flow reserve ( FFR ) estimation of the SB or final kissing balloon inflation ( FKBI ) after the MV stenting when a significant SB ostial stenosis is present. Even though FFR is recommended in CBL , there is concern about SB crossing with pressure guidewire among interventionists. Materials and methods We undertook a comprehensive literature search to identify all relevant studies reporting the failure rates of SB crossing after MV stenting with either pressure or coronary guidewire. A random effects model was used to compare the failure rates between the two approaches. Results Our search identified six studies that reported failure rates of SB crossing with a pressure guidewire ( n = 648) and 11 studies that reported failure rates of SB crossing with a coronary guide‐wire ( n = 2601). Estimated pooled failure rate was 3·9% (95% CI : 1·5% to 9·6%) for inability to cross SB with pressure guidewire. Estimated pooled failure rate of SB crossing with coronary guidewire was 3·1% (95% CI : 1·5% to 6·2%). There was no significant difference between the failure rates in the two groups ( P = 0·70). Conclusion The failure rates of SB crossing after MV stenting are low with both pressure and coronary guidewire procedures, with no significant difference between the two approaches.