title: Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent.
abstract: OBJECTIVE
  We evaluated differences in clinical outcomes between patients who underwent final kissing balloon inflation (FKBI) and patients who did not undergo FKBI in bifurcation treatment using the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina, USA).
  
  
  METHODS
  Clinical outcomes were defined as target vessel failure (composite of cardiac death, any myocardial infarction and clinically indicated target vessel revascularisation), cardiac death, myocardial infarction (MI), clinically indicated target vessel revascularisation and stent thrombosis. Cumulative event rates were estimated using the Kaplan-Meier method. A multivariable logistic regression analysis was performed to evaluate which factors were potentially associated with FKBI performance.
  
  
  RESULTS
  Follow-up data was available in 717 (96%) patients with a median follow-up of 190 days. Cardiac death at 1 year occurred more often in the no-FKBI group (1.7% vs 4.6%, respectively, p=0.017), although this difference was no longer observed after excluding patients presenting with ST segment elevation MI (1.6% vs 3.3%, p=0.133). No significant differences were observed concerning the other clinical outcomes. One-year target vessel failure rates were 10.1% in the no-FKBI group and 9.2% in the FKBI group (p=0.257). Multivariable logistic regression analysis identified renal dysfunction, ST segment elevation MI as percutaneous coronary intervention indication, narrow (<30°) bifurcation angle and certain stent platforms as being independently associated with unsuccessful FKBI.
  
  
  CONCLUSIONS
  A lower cardiac death rate was observed in patients in whom FKBI was performed compared with a selection of patients in whom FKBI could not be performed, probably explained by an unbalance in the baseline risk profile of the patients. No differences were observed regarding the other clinical outcomes.
authors.affiliation: Department of Cardiology, Academic Medical Center-University of Amsterdam, , Amsterdam, The Netherlands.
authors.forename: Maik J
authors.initials: MJ
authors.lastname: Grundeken
authors.forename: Maciej
authors.initials: M
authors.lastname: Lesiak
authors.forename: Solomon
authors.initials: S
authors.lastname: Asgedom
authors.forename: Eulogio
authors.initials: E
authors.lastname: Garcia
authors.forename: Armando
authors.initials: A
authors.lastname: Bethencourt
authors.forename: Michael S
authors.initials: MS
authors.lastname: Norell
authors.forename: Peter
authors.initials: P
authors.lastname: Damman
authors.forename: Pier
authors.initials: P
authors.lastname: Woudstra
authors.forename: Karel T
authors.initials: KT
authors.lastname: Koch
authors.forename: M Marije
authors.initials: MM
authors.lastname: Vis
authors.forename: Jose P
authors.initials: JP
authors.lastname: Henriques
authors.forename: Jan G
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: David P
authors.initials: DP
authors.lastname: Foley
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.forename: Pieter R
authors.initials: PR
authors.lastname: Stella
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.forename: Joanna J
authors.initials: JJ
authors.lastname: Wykrzykowska
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011474:Prosthesis Design; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: Coronary Artery Disease; Interventional Cardiology