Abstract 4343: Final Kissing versus Simple Balloon Post-dilatation in Patients With Bifurcation Lesions Treated With a Simple Approach
Purposes: Main vessel stent deformation after dilation of a side branch (SB) has been described in detail in bench studies. Kissing balloon inflation has been proposed to restore original stent geometry. However, there is little in vivo information available on these phenomena. Intravascular ultrasound studies (IVUS) would allow the assessment of changes in stent morphology after SB post-dilation. We performed a randomized comparison of ultrasound parameters in patients with bifurcation lesions treated with a simple approach (one main vessel drug-eluting stent).
Methods: We included 151 patients with bifurcation lesions who were successfully treated with a simple approach; 76 of them were randomly assigned to simultaneous final kissing balloon, while 75 underwent isolated SB balloon post-dilation.
Results: Mean age was 63±9 years, 112 (77%) were male. The target lesion was located in the left main in 15 cases (10%), in the left anterior descending in 76 (50%), in the circumflex in 39 (26%) and in the right coronary artery in 21 (14%). There were no significant differences among groups in terms of risk factors, clinical presentation or angiographic parameters. The table⇓ shows the immediate IVUS findings for both groups. At January 2009, 78 pts (52%) had completed one year clinical follow-up. At this time 8 patients had major adverse cardiac events with no significant differences between groups.
Conclusions: A certain degree of stent distortion under the side branch origin occurs after single balloon post-dilation. Final kissing balloon does not provide complete recovery of stent geometry, although the proximal segment stent area does increase significantly. No differences between groups in clinical outcome at 1-year follow-up were observed.