Long-term clinical outcomes after kissing balloon inflation in patients with coronary bifurcation lesions treated with provisional stenting technique. Results from the real-world multicenter registry

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Abstract

Objective

There is a lack of data regarding the long-term clinical efficacy of the kissing balloon inflation (KBI) after provisional stenting of coronary bifurcation lesions. The aim of this study was to analyze the impact of KBI on long-term clinical outcomes in patients undergoing provisional stenting for the coronary bifurcation lesions in a large real-world population.

Methods

A total of 873 patients who underwent percutaneous coronary interventions (PCI) with provisional stenting and had clinical follow up were analyzed. Patients treated with 2-stent strategy were excluded. To reduce the effect of potential confounding factors in this observational study, propensity score matching was conducted.

Results

KBI was performed in 325 patients (37.2%). The median follow-up duration was 37.3 months. Patients treated with KBI more often had a previous PCI (48.6% vs. 42.5% SMD = 0.123). Patients in non-kissing group had more complex coronary disease with higher prevalence of calcification (14.8% vs. 21.4% SMD = 0.172), thrombosis (2.8% vs. 5.8% SMD = 0.152) and longer side branch lesions (8.3% vs. 11.7% SMD = 0.113). There were no significant differences in the major adverse cardiac events including death, myocardial infarction, target lesion revascularization after KBI versus no KBI (15.4% vs. 15.7%, p = 0.28), in total cohort or in matched patients (17.1% vs. 15.8%, adjusted HR 1.01, 95% CI: 0.65–1.65, p = 0.95). The lack of effect of KBI on clinical outcomes was consistent across various subgroups including left main disease.

Conclusion

In this multicenter real-world registry, KBI did not improve long-term clinical outcomes in patients with coronary bifurcation lesions treated with provisional stenting technique.

Highlights

•

While POT considered as a mandatory step of the provisional stenting, efficacy of KBI is still questioned due to controversial data.
•

In this multicenter real-world registry KBI didn't improve clinical outcomes in patients treated with 1-stent technique.
•

The lack of effect of KBI on clinical outcomes was consistent across various subgroups including left main bifurcation.

Related collections

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Author and article information

Contributors

Dmitrii Khelimskii

Journal

Journal ID (nlm-ta): Indian Heart J

Journal ID (iso-abbrev): Indian Heart J

Title: Indian Heart Journal

Publisher: Elsevier

ISSN (Print): 0019-4832

ISSN (Electronic): 2213-3763

Publication date (Print): Sep-Oct 2023

Publication date (Electronic): 11 May 2023

Volume: 75

Issue: 5

Pages: 313-320

Affiliations

[a ]Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation

[b ]Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 625026, Russian Federation

[c ]Ural Federal University, Ekaterinburg, Russian Federation

Author notes

[∗ ]Corresponding author. 15 Rechkunovskaya st., Novosibirsk, 630055, Russia. dkhelim@ 123456mail.ru

Article

Publisher Item ID: S0019-4832(23)00075-5

DOI: 10.1016/j.ihj.2023.05.003

PMC ID: 10568054

PubMed ID: 37178866

SO-VID: 78c71070-2b2b-40af-92a9-315f7797c434

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).