title: Non-compliant balloons for final kissing inflation in coronary bifurcation lesions treated with provisional side branch stenting: a pilot study.
abstract: OBJECTIVE
  To assess the procedural and long-term results of non-compliant (NC) kissing balloon inflation (KB) in patients undergoing bifurcation intervention with the provisional side branch (SB) stenting technique. Provisional SB stenting is the default strategy for coronary bifurcation intervention. Recent data have suggested that KB with compliant balloons increases the risk of SB dissection and restenosis. However, NC KB may reduce SB complications.
  
  
  RESULTS
  We prospectively enrolled patients undergoing provisional SB stenting at two French centres. KB was systematically performed with NC balloons. Quantitative coronary angiography and digital stent enhancement (DSE) were performed in all cases. Thirty-day and one-year major adverse cardiac event (MACE) rates were assessed. We recruited 100 patients with a mean age of 67.3±11.7 years. Diabetes mellitus was prevalent in 23%, renal dysfunction in 21%, and multivessel disease in 69%. Intervention was performed for stable angina in 48% and acute coronary syndromes in 27%. Target lesions were the left main in 15% and the left anterior descending in 51%. True bifurcation stenoses accounted for 46% of lesions (Medina class: 1,1,1/1,0,1/0,1,1). All lesions were successfully treated with NC KB. SB stenting was required in 6% (five dissections, one residual stenosis). Using DSE, a SB stent scaffold was evident in 89% following KB. The cumulative 12-month MACE rate was 4%. Target lesion revascularisation was required in 3%. No stent thrombosis occurred during follow-up.
  
  
  CONCLUSIONS
  Provisional SB stenting followed by NC KB is associated with high procedural success and low rates of clinical target lesion failure.
authors.affiliation: Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques Cartier, Massy, France. darrenmylotte@gmail.com
authors.forename: Darren
authors.initials: D
authors.lastname: Mylotte
authors.forename: Thomas
authors.initials: T
authors.lastname: Hovasse
authors.forename: Abdelkader
authors.initials: A
authors.lastname: Ziani
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
authors.forename: Nicolas
authors.initials: N
authors.lastname: Dumonteil
authors.forename: Yves
authors.initials: Y
authors.lastname: Louvard
authors.forename: Didier
authors.initials: D
authors.lastname: Carrie
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D060050:Angina, Stable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D015331:Cohort Studies; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome