Comparative Study Of Balloon-Stent Kissing Technique Versus Jailed Wire Technique For The Interventional Treatment Of Coronary Bifurcation Lesions

Objective:To compare the immediate and long-term clinical outcome between Balloon-Stent Kissing Technique(BSKT)and Jailed Wire Technique(JWT)for the interventional treatment of coronary bifurcation lesions,to evaluate the result of BSKT for the treatment of coronary bifurcation lesions.Methods:From January 2013 to May 2016,89 patients with 90 true bifurcation lesions who were underwent PCI in Zhongshan Hospital Affiliated to Dalian University were enrolled into this study,and they were randomly divided into BSKT group(44 patients,45 lesions)and JWT group(45 patients,45 lesions).Single-stent strategy was the treatment principle,each group has finished the operation according to technical requirements.The operation successful rate,incidence of complications,the results of immediate quantitative coronary angiography and incidence of perioperative major adverse cardiovascular events(MACEs)were compared between the two groups.All patients were followed for 6-24 months,the incidence of long-term MACEs,angina pectoris and serious heart failure were compared between the two groups.Results:The operation successful rate of the each group was 100%.After main vessel(MV)stenting,BSKT was associated with a significantly lower rate of side branch(SB)occlusion(0% vs.15.6%,P<0.05)and side branch post-treatment(8.9% vs.26.7%,P<0.05)compared with JWT.BSKT was associated with a significantly lower degree of postoperative proximal MV residual stenosis [(6.1±5.1)%vs.(9.6±8.6)%,P<0.05]and SB ostial stenosis [(51.6±20.6)% vs.(70.3±20.8)%,P<0.05] compared with JWT.The incidence of perioperative MACEs(including cardiac death,myocardial infarction,target lesion revascularization,and stent thrombosis)was significantly lower in the BSKT group compared with JWT group(0% vs.13.3%,P<0.05).Patients were followed for a mean of 19.0±6.1 months.The incidence of long-term MACEs,angina CCS grade ≥2 and serious heart failure(NYHA grade Ⅳ)have no statistical significance(P>0.05)between the two groups.Conclusion:(1)BSKT has obvious advantage compared with JWT for side branch protection.BSKT has lower rate of SB occlusion and SB post-treatment compared with JWT,it has lower degree of postoperative proximal MV residual stenosis and SB ostial stenosis compared with JWT,it can significantly enhance the angiography results of the interventional treatment of coronary bifurcation lesions.(2)BSKT has lower incidence of perioperative MACEs compared with JWT.The immediate clinical outcome of BSKT is superior to JWT,the long-term clinical outcome of BSKT is not inferior to JWT,it has confirmed that BSKT is a safe and effective side branch protection technology.