title: Final kissing ballooning and long-term clinical outcomes in coronary bifurcation lesions treated with 1-stent technique: results from the COBIS registry.
abstract: BACKGROUND
  Whether final kissing ballooning (FKB) is mandatory in the 1-stent technique is uncertain.
  
  
  OBJECTIVE
  To evaluate the effect of FKB on long-term clinical outcomes in coronary bifurcation lesions treated with the 1-stent technique.
  
  
  METHODS
  Consecutive patients undergoing percutaneous coronary intervention using drug-eluting stents for non-left main bifurcation lesions were enrolled from 16 centres in Korea between January 2004 and June 2006. In patients treated with the 1-stent technique major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), or target lesion revascularisation (TLR)) were compared between those undergoing main vessel stenting only (non-FKB group, n=736) or those undergoing FKB after main vessel stenting (FKB group, n=329). Propensity score-matching analysis was also performed in 222 patient pairs (444 from the non-FKB group and 222 from the FKB group).
  
  
  RESULTS
  During follow-up (median 22 months), the FKB group had a higher incidence of MACE (HR 2.58; 95% CI 1.52 to 4.37; p<0.001) and TLR (HR 3.63; 95% CI 2.00 to 6.56; p<0.001), but not of cardiac death or MI. Most TLR occurred in the main vessel (HR 3.39 for the FKB group; 95% CI 1.86 to 6.19; p<0.001). The rate of stent thrombosis was similar in both groups (0.5% in the non-FKB group vs 0.6% in the FKB group, p=0.99). After propensity score matching, the FKB group still had higher rates of MACE and TLR than the non-FKB group (HR 2.13; 95% CI 1.15 to 3.95; p=0.02 and HR 2.84; 95% CI 1.45 to 5.55; p=0.002, respectively).
  
  
  CONCLUSIONS
  In patients treated with the 1-stent technique for bifurcation lesions, FKB after main vessel stenting may be harmful mainly due to increased TLR.
  
  
  BACKGROUND
  clinicaltrials.gov number: NCT00851526.
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hcgwon@skku.edu
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.forename: Joo-Yong
authors.initials: JY
authors.lastname: Hahn
authors.forename: Bon-Kwon
authors.initials: BK
authors.lastname: Koo
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Song
authors.forename: Seung-Hyuk
authors.initials: SH
authors.lastname: Choi
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Choi
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Myung-Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: In-Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Yang
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Yoon
authors.forename: Seung-Jea
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D002423:Cause of Death; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D057216:Propensity Score; D011474:Prosthesis Design; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome