title: Anatomical and functional assessment of Tryton bifurcation stent before and after final kissing balloon dilatation: Evaluations by three-dimensional coronary angiography, optical coherence tomography imaging and fractional flow reserve.
abstract: OBJECTIVE
  To assess the anatomical and functional impact of final kissing balloon inflation (FKBI) after implantation of a dedicated bifurcation stent system.
  
  
  BACKGROUND
  Current evidence suggests clinical benefit of FKBI in patients undergoing bifurcation dilatation using the Tryton side branch stent (Tryton-SBS). We hypothesized that FKBI improves anatomical reconstruction and functional results of bifurcation treated by Tryton-SBS.
  
  
  METHODS
  An unselected group of patients with complex bifurcation coronary lesions undergoing percutaneous coronary intervention (PCI) with Tryton-SBS underwent paired anatomical assessment with two- and three-dimensional quantitative coronary analysis (2D- and 3D-QCA), and optical coherence tomography (OCT), including 3D reconstruction before and after FKBI. Functional assessment by fractional flow reserve (FFR) was performed in the main branch (MB) and side branch (SB) before and after FKBI.
  
  
  RESULTS
  Paired pre- and post-FKBI data were obtained in 10 patients. By OCT imaging, FKBI increased both the SB ostial area (4.93 ± 2.81 vs. 7.43 ± 2.87 mm2, P < 0.001) and the SB maximum diameter (3.12 ± 0.98 vs. 3.82 ± 1.10 mm, P = 0.003). These findings were associated with a significant increase in FFR in the SB (0.90 ± 0.05 vs. 0.94 ± 0.03; P = 0.011), with no significant change in the MB (0.91 ± 0.05 vs. 0.92 ± 0.04; P = 0.470).
  
  
  CONCLUSIONS
  In patients with complex bifurcation stenosis undergoing PCI with a dedicated bifurcation system, FKBI is associated with improved anatomical and functional results at the SB level, without compromising the result at the MB. © 2016 Wiley Periodicals, Inc.
authors: Cardiovascular Research Center Aalst, OLV Clinic, Aalst, Belgium.|II. Medizinische Klinik, Klinikum Coburg, Coburg, Germany.
authors: Stylianos A
authors: SA
authors: Pyxaras
authors: Cardiovascular Research Center Aalst, OLV Clinic, Aalst, Belgium.|Department of Cardiology, University Heart Centre, Graz, Austria.
authors: Gabor G
authors: GG
authors: Toth
authors: Cardiovascular Research Center Aalst, OLV Clinic, Aalst, Belgium.
authors: Giuseppe
authors: G
authors: Di Gioia
authors: Department of Cardiovascular Medicine, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
authors: Giovanni J
authors: GJ
authors: Ughi
authors: School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
authors: Shengxian
authors: S
authors: Tu
authors: Cardiovascular Research Center Aalst, OLV Clinic, Aalst, Belgium.
authors: Dan
authors: D
authors: Rusinaru
authors: Department of Cardiovascular Medicine, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
authors: Tom
authors: T
authors: Adriaenssens
authors: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors: Johan H C
authors: JHC
authors: Reiber
authors: Center for Interventional Vascular Therapy, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York.
authors: Martin B
authors: MB
authors: Leon
authors: Department of Cardiology, Heart & Lung Centrum, Leiden University Medical Center, Leiden, The Netherlands.
authors: Jeroen J
authors: JJ
authors: Bax
authors: Cardiovascular Research Center Aalst, OLV Clinic, Aalst, Belgium.|The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group, Galway, Ireland.
authors: William
authors: W
authors: Wijns
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D006328:Cardiac Catheterization; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015607:Stents; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
keywords: bifurcation stenosis; dedicated bifurcation stent systems; final kissing balloon inflation; fractional flow reserve; optical coherence tomography; quantitative coronary angiography