title: Innovative provisional stenting approach to treat coronary bifurcation lesions: balloon-stent kissing technique.
abstract: BACKGROUND
  Adverse cardiac event rates are higher for percutaneous coronary intervention (PCI) of bifurcation lesions. Currently, provisional stenting or a simple stenting strategy is the standard treatment for bifurcated lesions, but its performance remains limited because of a risk of side-branch (SB) closure and a higher rate of target lesion revascularization (TLR). We report a new provisional side-branch stenting strategy to treat coronary bifurcation lesions using a "balloon-stent kissing" technique (BSKT).
  
  
  METHODS
  From January 2011 to December 2012, a total of 60 patients with 60 bifurcation lesions underwent PCI using BSKT. Baseline and postprocedural quantitative coronary angiography (QCA) analyses were performed. Procedural and immediate clinical outcomes were reviewed.
  
  
  RESULTS
  The majority of patients presented with acute coronary syndrome (98%) and had true bifurcation lesions (98%). TIMI-3 flow was established in 100% of the main branch and SB lesions. QCA revealed preservation of the bifurcation angle after PCI (pre PCI, 57.0 ± 16.3; post PCI, 60.5 ± 16.1; P=.24). Five patients (8%) had lesions that required rewiring and 2 patients (3%) required provisional stenting of the SB. No SB loss occurred during PCI. No patient had a periprocedural myocardial infarction, nor was the balloon or wire entrapped during any PCI.
  
  
  CONCLUSIONS
  As a new coronary bifurcation provisional stenting method, the BSKT is associated with a high procedural success rate, improved SB patency, and a low rate of immediate cardiac events.
authors.affiliation: Department of Cardiology, the Affiliated Zhongshan Hospital of Dalian University, 6 Jiefang Road, Zhongshan, Dalian 116001, China. lilonghu75@hotmail.com.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Jin
authors.forename: Longhu
authors.initials: L
authors.lastname: Li
authors.forename: Meilan
authors.initials: M
authors.lastname: Wang
authors.forename: Shuying
authors.initials: S
authors.lastname: Zhang
authors.forename: Zongwei
authors.initials: Z
authors.lastname: Chen
authors.forename: Zhitao
authors.initials: Z
authors.lastname: Shen
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional