title: Kissing inflation is feasible with all second-generation drug-eluting balloons.
abstract: OBJECTIVE
  To assess the feasibility of kissing second-generation drug-eluting balloons (DEB), which have better mechanical properties than the first-generation DEB, in order to optimize provisional bare-metal stenting (BMS) when treating coronary bifurcation lesions in patients with contraindication to drug-eluting stents.
  
  
  METHODS
  Consecutive patients with anticipated low compliance to dual antiplatelet therapy who are undergoing provisional stenting with an open-cell design BMS and final kissing balloon with second-generation DEB were enrolled in this feasibility study. Angiographic success and procedural success (i.e., angiographic success in absence of in hospital major cardiovascular events) were registered. Clinical follow-up was also attempted in all patients.
  
  
  RESULTS
  A total of 14 patients (mean age 66±9 years, nine men) participated on the study. The DEB used were SeQuent Please (B. Braun Melsungen, Berlin, Germany) in six patients, In.Pact Falcon (Medtronic Invatec, Roncadelle, Italy) in four patients, New Dior (Eurocor, Bonn, Germany) in two patients and Pantera Lux (Biotronik, Berlin, Germany) in another two patients. All procedures, but one, were performed by transradial access through a 6-French high-flow guiding catheter. True bifurcation was present in 50% of the patients. Angiographic and procedural success was obtained in all patients. At a mean follow-up of 234±81 days, all contacted patients were asymptomatic and free from major adverse cardiac events (including cardiac death, nonfatal myocardial infarction and target bifurcation revascularization).
  
  
  CONCLUSIONS
  At the advent of dedicated bifurcation stents, kissing DEB appears safe and effective and can be used to implement innovative, simpler, safer and possibly more effective bifurcation techniques. These remarkable results have laid the ground for an ongoing prospective registry of the kissing DEB technique (KISSING DEBBIE study, ClinicalTrials.gov NCT01009996).
authors.affiliation: UOC Emodinamica e Cardiologia Interventistica, Ospedale Santa Maria Goretti, Latina, Italy. g.a.sgueglia@gmail.com
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Sgueglia
authors.forename: Daniel
authors.initials: D
authors.lastname: Todaro
authors.forename: Andrea
authors.initials: A
authors.lastname: Bisciglia
authors.forename: Micaela
authors.initials: M
authors.lastname: Conte
authors.forename: Antonino
authors.initials: A
authors.lastname: Stipo
authors.forename: Edoardo
authors.initials: E
authors.lastname: Pucci
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D000075202:Contraindications; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents