title: Impact of final kissing balloon inflation on vessel healing following drug-eluting stent implantation: Insight from the optical coherence tomography sub-study of the J-REVERSE trial.
abstract: We sought to clarify the impact of final kissing inflation (FKI) after single stenting of bifurcation lesions on vessel healing.
  
  
  
  From the J-REVERSE registry enrolling 303 bifurcation lesions treated with provisional single stenting using sirolimus- (SES) or everolimus-eluting stent (EES), 65 lesions treated with (n=30) and without (n=35) FKI underwent 9-month follow-up optical coherence tomography. Average stent eccentricity index (SEI: minimum/maximum stent diameter) and neointimal unevenness score (NUS: maximum/average neointimal thickness of the same cross-section) for the proximal, bifurcation, and distal segments were compared between FKI and non-FKI groups.
  
  
  
  At the proximal segment, the FKI group demonstrated significantly larger average stent area with greater asymmetric stent expansion, and average lumen area remained significantly larger at 9-month follow-up despite a tendency toward greater neointimal proliferation. Jailed strut and thrombus incidence were also significantly lower at the side branch orifice, and NUS was significantly smaller at the bifurcation and proximal segments in the FKI group.
  
  
  
  Nine months after SES and EES treatment of bifurcation lesions, FKI reduced proximal-segment luminal narrowing. Considering its homogeneous neointimal distribution and fewer jailed struts, FKI may be beneficial for treating bifurcation lesions.
authors.affiliation: Department of Cardiovascular Medicine, Kobe University, Kobe, Japan.
authors.forename: Hachidai
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Medicine, Kobe University, Kobe, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.affiliation: Department of Cardiovascular Medicine, Kobe University, Kobe, Japan. Electronic address: shinke@med.kobe-u.ac.jp.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.affiliation: Department of Cardiology, Cardiovascular Center, Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Murasato
authors.affiliation: Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kinoshita
authors.affiliation: Department of Cardiovascular Medicine, Saiseikai Yokohama-Eastern Hospital, Yokohama, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamawaki
authors.affiliation: Department of Cardiovascular Medicine, Rinku General Medical Center, Izumi-Sano, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Department of Cardiovascular Medicine, Hyogo Medical College, Nishinomiya, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of Cardiovascular Medicine, Himeji Cardiovascular Center, Himeji, Japan.
authors.forename: Shin-Ichiro
authors.initials: SI
authors.lastname: Yamada
authors.affiliation: Department of Cardiovascular Medicine, Shiroyama Hospital, Habikino, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Shimada
authors.affiliation: Department of Cardiovascular Medicine, Cardiovascular Center Hokkaido Ono Hospital, Sapporo, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: Department of Cardiovascular Medicine, Yokohama Rosai Hospital, Yokohama, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yumoto
authors.affiliation: Department of Cardiovascular Medicine, Kobe University, Kobe, Japan.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Hirata
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000601:surgery; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058426:Neointima / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012042:Registries; D041623:Tomography, Optical Coherence
keywords: Coronary bifurcation; Drug-eluting stent; Optical coherence tomography