title: Optimal kissing balloon inflation after single-stent deployment in a coronary bifurcation model.
abstract: OBJECTIVE
  To define the optimal kissing balloon inflation (KBI) after single-stent deployment in a coronary bifurcation model.
  
  
  RESULTS
  We deployed stents in main vessels (MV) followed by KBI in various conditions and compared the stent configurations. A) KBI at the operator's discretion vs. under the guidelines of minimal balloon overlapping (MBO). Various stent configurations were observed after the former option, whereas similar maximal dilation points were observed under the MBO guidelines. B) Long balloon overlapping (LBO) vs. MBO with proximal MV dilated by a large balloon. The proximal MV was dilated to an ideal round shape with MBO versus an oval shape with LBO. C) Two-link vs. 3-link stents. Although the 2-link stent was advantageous to open the side branch, it incurred a risk of overdilatation of the proximal struts, whereas the 3-link stent preserved its structure. Computed simulations of coronary flow were analysed in the following left main coronary models: circle with a diameter of 4 and 5.5 mm, ellipse with longitudinal direction and tilt position. They revealed that the overdilated side was exposed to low shear stress regardless of its shape.
  
  
  CONCLUSIONS
  Optimal KBI can be achieved with MBO and proximal dilatation by an optimally sized balloon.
authors: Department of Cardiovascular Medicine, Heart Center, New Yukuhashi Hospital, Yukuhashi, Japan.
authors: Yoshinobu
authors: Y
authors: Murasato
authors: Kiyotaka
authors: K
authors: Iwasaki
authors: Tadashi
authors: T
authors: Yamamoto
authors: Takanobu
authors: T
authors: Yagi
authors: Yutaka
authors: Y
authors: Hikichi
authors: Yasunori
authors: Y
authors: Suematsu
authors: Tomohiko
authors: T
authors: Yamamoto
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003198:Computer Simulation; D003326:Coronary Circulation; D023903:Coronary Restenosis; D006801:Humans; D008953:Models, Anatomic; D011474:Prosthesis Design; D015607:Stents