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Baig I, Lee AJ, Brinkman W, Gopal A, Dasi LP, Al-Azizi K. Simultaneous Kissing Balloon Inflation of the Transcatheter Aortic Valve Replacement Valve and an Ostial Coronary Stent-A Novel Coronary Protection Technique. Struct Heart 2022; 6:100074. [PMID: 37288126 PMCID: PMC10242579 DOI: 10.1016/j.shj.2022.100074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/21/2022] [Accepted: 06/27/2022] [Indexed: 06/09/2023]
Affiliation(s)
- Imran Baig
- Baylor Scott & White Health The Heart Hospital - Plano, Plano, Texas, USA
| | - Arthur J. Lee
- Baylor Scott & White Health The Heart Hospital - Plano, Plano, Texas, USA
| | - William Brinkman
- Baylor Scott & White Health The Heart Hospital - Plano, Plano, Texas, USA
| | - Ambarish Gopal
- Baylor Scott & White Health The Heart Hospital - Plano, Plano, Texas, USA
| | - Lakshmi Prasad Dasi
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Karim Al-Azizi
- Baylor Scott & White Health The Heart Hospital - Plano, Plano, Texas, USA
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Yang H, Song Y, Cao J, Weng X, Zhang F, Dai Y, Lu H, Li C, Huang Z, Qian J, Ge J. Double kissing inflation outside the stent secures the patency of small side branch without rewiring. BMC Cardiovasc Disord 2021; 21:232. [PMID: 33962571 PMCID: PMC8106182 DOI: 10.1186/s12872-021-02028-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The jailed balloon technique is widely used for coronary bifurcation lesions, but a residual risk of SB occlusion remains, necessitating SB rewiring and further interventions, including balloon inflation or stenting, which may result in failure and SB loss. This study introduced a novel modified technique of small side branch (SB) protection, namely, double kissing inflation outside the stent (DKo) technique, for coronary bifurcations without the need for SB rewiring. METHODS We performed the DKo technique in consecutive patients in our center from 1/2019 to 12/2019. The procedure was as follows. We inserted a guide wire into both branches followed by proper preparation. The SB balloon was simultaneously inflated with main vessel (MV) stenting. The SB balloon remained in situ until it was kissing inflated with postdilation of the bifurcation core, which is different from traditional strategies. The proximal optimization technique was performed with a short noncompliant balloon strictly not exceeding the bifurcation. Rates of SB loss and in-hospital outcomes were evaluated. RESULTS The technique was successfully performed in all 117 enrolled patients without any rewiring or SB loss. The mean lesion lengths of the MV and SB were 38.3 ± 19.9 mm and 11.7 ± 7.1 mm, respectively. On average, 1.5 ± 0.6 stents were used per patient, while the mean pressure of the SB balloon was 7.4 ± 3.1 atm. DKo achieved excellent procedural success in the proximal and distal MVs: increased minimal lumen diameter (0.64 ± 0.58 mm to 3.05 ± 0.38 mm, p < 0.001; 0.57 ± 0.63 mm to 2.67 ± 0.35 mm, p < 0.001) and low residual stenosis (11.4 ± 3.4%; 7.2 ± 4.6%). DKo secured the patency of the SB without any rewiring and improved the SB stenosis with minimal lumen diameter (0.59 ± 0.48 mm to 1.20 ± 0.42 mm, p < 0.001) and stenosis (71.9 ± 19.4% to 42.2 ± 14.0%, p < 0.001). No MACE was noted in the hospital. CONCLUSIONS DKo for bifurcation lesions was shown to be acceptable with high procedural success and excellent SB protection.
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Affiliation(s)
- Hongbo Yang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
| | - Yanan Song
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
| | - Jiatian Cao
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
| | - Xueyi Weng
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
| | - Feng Zhang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
| | - Yuxiang Dai
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
| | - Hao Lu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
| | - Chenguang Li
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
| | - Zheyong Huang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China.
| | - Juying Qian
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China.
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Xietu Road No. 1609, Shanghai, 200032, People's Republic of China
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Hitora Y, Teraoka T, Tanaka A, Uemura Y, Tobe A, Sakakibara K, Miki Y, Kataoka T, Niwa K, Tashiro H, Furusawa K, Takemoto K, Watarai M, Kimura A, Ishii H, Murohara T. Clinical outcomes following percutaneous coronary intervention for bifurcation lesions: kissing balloon inflation vs. sequential dilation. Cardiovasc Interv Ther 2021; 36:436-43. [PMID: 33164158 DOI: 10.1007/s12928-020-00728-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/22/2020] [Indexed: 02/06/2023]
Abstract
Percutaneous coronary intervention for bifurcation lesions remains challenging, with there being several debatable issues, including the requirement for kissing balloon inflation (KBI). The objective of this study was to assess the clinical outcomes following single crossover stent implantation with KBI or sequential dilation alone. Data were examined for 255 non-left main bifurcation lesions (246 patients) treated with single crossover stent implantation, followed by side branch (SB) strut dilation with KBI (n = 74 lesions) or sequential dilation (n = 181 lesions) in three hospitals. Target lesion revascularization (TLR) was the primary endpoint. There was no significant difference in the pre-procedural reference diameter of both the main vessel (MV) and SB between the KBI and sequential dilation groups. However, MV post-dilation balloon size was smaller with lower pressure and post-procedural minimal lumen diameter was significantly smaller in the KBI group. During the median follow-up period of approximately 3 years, TLR incidence was significantly higher in the KBI group than in the sequential dilation group; in particular, the TLR rate at the distal MV was higher in the former. For bifurcation lesions treated with single crossover stent implantation, the TLR rate was higher after KBI than after sequential dilation; this was mainly due to higher revascularization in the distal MV. For bifurcation lesions treated with KBI, MV post-dilation balloon diameter tended to be smaller with lower pressure, which might lead to poorer stent expansion and a higher TLR rate.
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Du BB, Tong YL, Wang XT, Liu GH, Liu K, Yang P, He YQ. Rescue treatment and follow-up intervention of a left main acute myocardial infarction with typical carina shift under 3D optical coherence tomography: A case report. World J Clin Cases 2020; 8:848-853. [PMID: 32149070 PMCID: PMC7052562 DOI: 10.12998/wjcc.v8.i4.848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/31/2019] [Accepted: 01/08/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Coronary intervention for bifurcation lesions is still challenging for interventional cardiologists. Left main (LM) bifurcation lesions have a higher risk due to the vast blood supply in this area and treatment choice is difficult. Ostial compromise of the side branch decreases patient prognosis, and its management is still an issue despite the different strategies and devices available.
CASE SUMMARY A 42-year-old male patient was admitted to hospital due to chest pain and syncope. Coronary angiography showed acute LM occlusion. Following thrombus aspiration, a LM bifurcation lesion remained. Coronary angiography was repeated one week later, and at the same time, 3D optical coherence tomography (OCT) was carried out to better show the geometry of the bifurcation, which confirmed that the stenosis in the ostial left circumflex artery was caused by a long carina. After assessment of the plaque characteristics and the minimum lumen area, the cross-over strategy, kissing balloon inflation and proximal optimization technique were chosen to treat the bifurcation lesion. A “moving” carina was found twice during the intervention. Good stent apposition and expansion were confirmed by OCT after proximal optimization technique. The three-month follow-up showed good recovery and normal cardiac function.
CONCLUSION 3D-OCT can facilitate decision-making for coronary interventions in patients with critical bifurcation lesions.
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Affiliation(s)
- Bei-Bei Du
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
| | - Ya-Liang Tong
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
| | - Xing-Tong Wang
- Department of Hematology and Oncology, Cancer Center, The First Hospital of Jilin University, Changchun 130031, Jilin Province, China
| | - Guo-Hui Liu
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
| | - Kun Liu
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
| | - Ping Yang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
| | - Yu-Quan He
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
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Fujimura T, Okamura T, Furuya K, Miyazaki Y, Takenaka H, Tateishi H, Oda T, Mochizuki M, Uchinoumi H, Nishimura T, Yamada J, Yano M. Comparison of diagnostic performance in assessing the rewiring position into a jailed side branch between online 3D reconstruction systems version 1.1 and 1.2 derived from optical frequency domain imaging. Cardiovasc Interv Ther 2019; 35:336-342. [PMID: 31707692 PMCID: PMC7497438 DOI: 10.1007/s12928-019-00629-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 10/16/2019] [Indexed: 11/23/2022]
Abstract
The three-dimensional reconstruction of optical coherence tomography and optical frequency domain imaging (3D-OCT/OFDI) helps optimize bifurcation percutaneous coronary interventions (PCIs) with side branch (SB) dilatation by identifying the optimal rewiring position. 3D-OCT/OFDI’s diagnostic performance for assessing the rewiring position into a jailed SB is unknown. We retrospectively evaluated the diagnostic performances of a conventional (ver. 1.1) and a new (ver. 1.2) online 3D-OFDI reconstruction system based on an offline 3D reconstruction system’s performance. We analyzed 45 patients’ 52 OFDI pullbacks with main vessel stenting followed by rewiring into a jailed SB for coronary bifurcation lesions. We counted the undetected stent struts in the polygon of confluence as the stent detection performance. We assessed the diagnostic agreement regarding the rewiring position into a jailed SB by the three 3D reconstruction systems. The percentage of undetected struts and the diagnostic agreement of ver.1.2 were significantly better than those of ver.1.1 [5.1 ± 5.1% vs. 30.2 ± 14.2%; p < 0.0001, and 94.2% (49/52) vs. 76.9% (40/52); p = 0.0120]. The new online 3D-OFDI reconstruction system provides better diagnostic performance than the conventional online system for assessing the rewiring position into a jailed SB.
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Affiliation(s)
- Tatsuhiro Fujimura
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Takayuki Okamura
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
| | - Kazuki Furuya
- Department of Clinical Engineering, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Yosuke Miyazaki
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Hitoshi Takenaka
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Hiroki Tateishi
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Tetsuro Oda
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Mamoru Mochizuki
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Hitoshi Uchinoumi
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Takashi Nishimura
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Jutaro Yamada
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Masafumi Yano
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
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Warisawa T, Kuwata S, Kasahara M, Doi S, Nakayama Y, Suzuki N, Takai M, Matsuda H, Mizuno K, Akashi YJ. Feasibility of kissing balloon technique through guide extension catheters: an experimental bench test. Cardiovasc Interv Ther 2020; 35:269-75. [PMID: 31541392 DOI: 10.1007/s12928-019-00622-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 09/11/2019] [Indexed: 11/27/2022]
Abstract
Previous reports showed that GuideLiner (GL) and Guidezilla (GZ) can accommodate bulky and multiple devices beyond the official profiles. However, feasibility of kissing balloon technique (KBT) through these devices is unknown. The tested devices included 7Fr-GL/GZ and respective three types of 2.5 mm semi-compliant (SC) and non-compliant (NC) balloons: conventional model (CM), tapered-tip model (TM) and latest model (LM). First, three experienced operators attempted to advance all 21 combinations of the 2 balloons through GL/GZ on the guidewires and assessed the crossability in 3 grades: easy, difficult and impossible. Second, the only balloon combinations graded as easy by all operators were tested in the polyurethane-made bifurcation model which required KBT following cross-over stenting. Within the total of 42 device combinations, only one balloon combination of double LM-NC balloons was classified as easy in both GL/GZ by consensus opinion of the operators. While two combinations of LM-SC and LM-SC/NC balloons were classified as difficult in both GL/GZ, all four combinations of LM-SC/NC and CM/TM-NC balloons were classified as difficult only in GL. Other 32 combinations were all classified as impossible. In the bifurcation model, the combination of double LM-NC balloons using GL achieved KBT while the same balloon combination with GZ failed. The feasibility of KBT using child-catheter is highly dependent on the device characteristics. The combination of latest small-profile NC balloons through GL could be clinically applicable.
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Nagoshi R, Okamura T, Murasato Y, Fujimura T, Yamawaki M, Ono S, Serikawa T, Hikichi Y, Nakao F, Sakamoto T, Shinke T, Kijima Y, Kozuki A, Shibata H, Shite J. Data on two- and three-dimensional optical coherence tomography guidance for the treatment for the bifurcation lesion. Data Brief 2017. [PMID: 29541673 PMCID: PMC5847640 DOI: 10.1016/j.dib.2017.12.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This article comprised the data related to the research article entitled “Feasibility and usefulness of three-dimensional optical coherence tomography guidance for optimal side branch treatment in coronary bifurcation stenting” (Nagoshi et al., In press) [1]. In this article we reports details about two patterns of guide wire (GW) recrossing position after crossover stenting in bifurcation lesion classified with three-dimensional optical coherence tomography (3D-OCT) (Okamura et al., 2014) [2] and follow-up data about the treatment with percutaneous coronary intervention(PCI) for bifurcation lesion in terms of the two- (2D) or 3D-OCT guidance. Subgroup analysis about differences in the parameters between the proximal and the distal GW recrossing patterns are analyzed here.
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Affiliation(s)
- Ryoji Nagoshi
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Takayuki Okamura
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Japan
| | | | - Tatsuhiro Fujimura
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama Eastern Hospital, Japan
| | - Shiro Ono
- Department of Cardiology, Saiseikai Yamaguchi General Hospital, Japan
| | - Takeshi Serikawa
- Department of Cardiology, Saiseikai Fukuoka General Hospital, Japan
| | | | - Fumiaki Nakao
- Department of Cardiology, Yamaguchi Central General Hospital, Japan
| | - Tomohiro Sakamoto
- Department of Cardiology, Saiseikai Kumamoto General Hospital, Japan
| | - Toshiro Shinke
- Department of Cardiology, Kobe University Graduate School of Medicine, Japan
| | - Yoichi Kijima
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Amane Kozuki
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Hiroyuki Shibata
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Junya Shite
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
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Nagoshi R, Okamura T, Murasato Y, Fujimura T, Yamawaki M, Ono S, Serikawa T, Hikichi Y, Nakao F, Sakamoto T, Shinke T, Kijima Y, Kozuki A, Shibata H, Shite J. Feasibility and usefulness of three-dimensional optical coherence tomography guidance for optimal side branch treatment in coronary bifurcation stenting. Int J Cardiol 2017; 250:270-274. [PMID: 29030141 DOI: 10.1016/j.ijcard.2017.09.197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/10/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND For the treatment of coronary bifurcation lesions, optimal guidewire (GW) recrossing after main vessel stenting is important for good stent apposition at the side branch (SB) orifice in kissing balloon inflation (KBI). METHODS We analyzed 150 bifurcation lesions treated with single stenting following KBI in the three-dimensional optical coherence tomography (3D-OCT) bifurcation registry study (2015-16) and a single center experience (2012-16). OCT examination was performed after GW recrossing to the SB and after KBI. Patients were divided into two-dimensional (2D, n=78) and 3D groups (n=72) according to 2D- or 3D-OCT guidance. GW recrossing position, jailing configuration of the stent over the SB (divided into Link-connecting type: stent link connecting to the carina and Link-free type: no stent link at the carina) and stent apposition were compared between the groups. RESULTS Distal GW recrossing was achieved in 75.6% and 91.7% in the 2D and 3D groups, respectively (P=0.004). Compared with the 2D group, the incidence of incomplete stent apposition (ISA) toward the SB in the 3D group tended to be lower in the whole cohort (14.5±13.6% vs 10.0±9.0%, P=0.077), and was significantly lower in left main trunk bifurcations (18.7±12.8% vs 10.3±8.9%, P=0.014). Independent contributors to ISA were the Link-connecting type (β 0.089, P<0.001), distal GW recrossing (β -0.078, P=0.001), and age (β -0.0020, P=0.012). CONCLUSION Optimal GW recrossing under 3D-OCT guidance is feasible and improves stent apposition, which may lead to a better clinical outcome in the treatment of bifurcation lesions.
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Affiliation(s)
- Ryoji Nagoshi
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Takayuki Okamura
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Japan
| | | | - Tatsuhiro Fujimura
- Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama Eastern Hospital, Japan
| | - Shiro Ono
- Department of Cardiology, Saiseikai Yamaguchi General Hospital, Japan
| | - Takeshi Serikawa
- Department of Cardiology, Saiseikai Fukuoka General Hospital, Japan
| | | | - Fumiaki Nakao
- Department of Cardiology, Yamaguchi Central General Hospital, Japan
| | - Tomohiro Sakamoto
- Department of Cardiology, Saiseikai Kumamoto General Hospital, Japan
| | - Toshiro Shinke
- Department of Cardiology, Kobe University Graduate School of Medicine, Japan
| | - Yoichi Kijima
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Amane Kozuki
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Hiroyuki Shibata
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Junya Shite
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Japan.
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Naganuma T, Mitomo S, Yabushita H, Kawamoto H, Nakao T, Lazarevic A, Nakamura S. Kissing balloon inflation in the aortic valve and left main stem: A novel coronary protection technique. Int J Cardiol 2016; 223:571-573. [PMID: 27561162 DOI: 10.1016/j.ijcard.2016.08.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 08/08/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Toru Naganuma
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
| | - Satoru Mitomo
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | | | | | - Tatsuya Nakao
- Department of Cardiovascular Surgery, New Tokyo Hospital, Chiba, Japan
| | - Aleksandar Lazarevic
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan; University Clinical Center Banja Luka, Banja Luca, Bosnia and Herzegovina
| | - Sunao Nakamura
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
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Leesar MA, Hakeem A, Azarnoush K, Thuesen L. Coronary bifurcation lesions: Present status and future perspectives. Int J Cardiol 2015; 187:48-57. [PMID: 25828312 DOI: 10.1016/j.ijcard.2015.03.183] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
Abstract
Coronary bifurcation lesions (CBLs) are challenging and associated with a higher rate of adverse events than non-bifurcation lesions. In the era of drug-eluting stents, 2 primary interventional strategies for treating CBL include the complex strategy the main vessel (MV) and side-branch (SB) stenting, and the simple strategy MV stenting combined with provisional SB stenting. The meta-analysis of the simple vs. complex strategies demonstrated an increased incidence of myocardial infarction in the complex strategy. Likewise, the Tryton dedicated bifurcation stents, as compared with the simple strategy, increased the rate of myocardial infarction. In contrast, the Nordic-Baltic Bifurcation Study IV demonstrated that event rates were not significantly different comparing the simple vs. complex strategies in true bifurcation lesions involving a large SB. Fractional flow reserve (FFR) has emerged as a powerful catheter based tool for the functional assessment of a stenosis, but the role of FFR on the long-term outcomes of patients with CBL has not been studied. Given the recent evidence that Tryton stents (a dedicated bifurcation stent) increased event rates, and the lack of benefit from using 2-stent techniques (the Nordic Baltic Bifurcation Study IV) in true CBL, assessing the FFR of the SB seems now of outmost importance, but randomized data are lacking. An intravascular study showed that kissing balloon inflation (KBI) significantly reduced SB stenosis, restored stent lumen at the carina, and expanded stent in the proximal segment. However, a recent randomized study showed no significant benefit of routine KBI. This review highlights current concepts and future perspectives in patients with CBL.
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Affiliation(s)
| | - Abdul Hakeem
- University of Arkansas Health Sciences Center, United States
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Nomura T, Higuchi Y, Kato T, Keira N, Tatsumi T. A rare instructive complication of balloon catheter fracture during percutaneous coronary intervention. Cardiovasc Interv Ther 2015; 31:70-4. [PMID: 25708708 DOI: 10.1007/s12928-015-0322-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 02/12/2015] [Indexed: 11/27/2022]
Abstract
The entrapment, fracture, and dislodgement of catheterization devices during percutaneous coronary intervention (PCI) are rare complications, for which cardiac surgery is sometimes required. Here, we encountered a rare but instructive case of balloon catheter fracture during PCI. Although there have been some reports of guidewire fracture in PCI, reports on balloon catheter fracture are very rare to our knowledge. A simulation test to examine the mechanism of balloon catheter fracture revealed that overuse of the balloon catheter, both for kissing balloon inflation and balloon anchor, was highly likely to have been the cause of the fracture.
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Affiliation(s)
- Tetsuya Nomura
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
| | - Yusuke Higuchi
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan
| | - Taku Kato
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan
| | - Natsuya Keira
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan
| | - Tetsuya Tatsumi
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan
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12
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Jim MH. Side branch ostium stenting with main vessel drug-eluting balloon kissing (BOMB): an innovative approach for isolated coronary stenosis at side branch ostium. Int J Cardiol 2013; 168:4939-40. [PMID: 23907034 DOI: 10.1016/j.ijcard.2013.07.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/02/2013] [Accepted: 07/08/2013] [Indexed: 11/20/2022]
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