title: Potential benefit of final kissing balloon inflation after single stenting for the treatment of bifurcation lesions--insights from optical coherence tomography observations.
abstract: BACKGROUND
  Treatment of coronary bifurcation lesions using a single stenting strategy is preferable over that using a 2-stent technique. The benefit of final kissing inflation (FKI), however, has not been established.
  
  
  RESULTS
  Seventy-two patients (76 lesions) with true bifurcation lesions treated with a single drug-eluting stent with FKI (n=33 lesions) or without FKI (non-FKI, n=43 lesions) were enrolled in this study. Optical coherence tomography (OCT) was performed at 6-12 months after implantation. Based on the OCT findings, the percentage of jailing struts (number of jailing struts/total number of struts at the bifurcation lesion) was calculated. Percentage of uncovered struts and frequency of thrombus attachment were each evaluated at the proximal, bifurcation, and distal segments. Major adverse cardiac events (MACE) were also evaluated. The percentage of jailing struts was significantly lower in the FKI than in the non-FKI group (5.8±6.2% vs. 17.3±6.1%, P<0.01). Thrombus attachment was less frequent in the FKI group (24.2% vs. 46.5%, P=0.046), especially at side-branch orifices (3.0% vs. 27.9%, P<0.001). The percentage of uncovered struts was lower in the FKI than non-FKI group at the proximal, bifurcation, and distal segments. The incidence of MACE was not different in this small cohort.
  
  
  CONCLUSIONS
  FKI might reduce the frequency of subclinical thrombus possibly by reducing the number of jailing struts.
authors: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Hirotoshi
authors: H
authors: Hariki
authors: Toshiro
authors: T
authors: Shinke
authors: Hiromasa
authors: H
authors: Otake
authors: Junya
authors: J
authors: Shite
authors: Masayuki
authors: M
authors: Nakagawa
authors: Takumi
authors: T
authors: Inoue
authors: Tsuyoshi
authors: T
authors: Osue
authors: Masamichi
authors: M
authors: Iwasaki
authors: Yu
authors: Y
authors: Taniguchi
authors: Ryo
authors: R
authors: Nishio
authors: Noritoshi
authors: N
authors: Hiranuma
authors: Hiroto
authors: H
authors: Kinutani
authors: Akihide
authors: A
authors: Konishi
authors: Ken-ichi
authors: K
authors: Hirata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000473:pathology / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome