title: Benefit of Final Kissing Balloon Inflation Mandatory After Simple Crossover Stenting for Left Main Bifurcation Narrowing.
abstract: The role of final kissing balloon (FKB) inflation after simple crossover stenting in unprotected left main (LM) bifurcation stenosis remains unknown. From the Asan Medical Center-Left Main Revascularization (ASAN-MAIN) registry, 413 patients with LM bifurcation stenosis treated by simple crossover stenting with a drug-eluting stent were identified. After simple crossover stenting, FKB inflation was performed in 95 patients (FKB group) and 318 patients finished the procedure without FKB (no-FKB group). The primary end points of the 2-year incidence of major adverse cardiac events (death, myocardial infarction, and left main target lesion revascularization [LM-TLR]) were similar between the FKB and no-FKB groups (12.5% vs 8.5%, p = 0.24). After adjustment, the risk of major adverse cardiac event was not significantly different between the FKB and the no-FKB groups (hazard ratio [HR] 1.10, 95% confidence interval [CI] 0.49 to 2.49; p = 0.82). The risk of death (HR 1.03, 95% CI 0.28 to 3.82; p = 0.98), the composite of death or myocardial infarction (HR 0.95, 95% CI 0.26 to 3.51; p = 0.96), or LM-TLR (HR 1.32, 95% CI 0.46 to 3.75; p = 0.60) were not significantly different between groups. In conclusions, for the treatment for LM bifurcation stenosis, selective, not mandatory, FKB strategy after simple crossover stenting appears to be associated with a favorable outcome.
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Ahn
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Pil Hyung
authors.initials: PH
authors.lastname: Lee
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kang
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.affiliation: Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: sjpark@amc.seoul.kr.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002423:Cause of Death; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome