Final kissing balloon dilatation in patients with coronary bifurcation lesions treated with an upfront provisional stenting strategy. in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology / EuroIntervention. 2025 Mar 17;21(6):e318-e328. doi: 10.4244/EIJ-D-24-00471.

2025
ASL Città di Torino
AOU Città della Salute di Torino

Tipo pubblicazione

Journal Article

Autori/Collaboratori (36)Vedi tutti...

Patti G
Division of Cardiology, Cardiovascular and Thoracic Department, A.O.U. Città della Salute e della Scienza, Turin, Italy.
Campo G
Hospital Clínico San Carlos IdISSC, Complutense University of Madrid and CIBER-CV, Madrid, Spain.
Escaned J
IRCCS Humanitas Research Hospital, Rozzano, Italy.

et alii...

Abstract

BACKGROUND: The impact of final kissing balloon inflation (FKB) in patients treated with an upfront provisional strategy for coronary bifurcation lesions is controversial. AIMS: We aimed to assess the impact of FKB on patient- and lesion-oriented outcomes in a large real-world cohort. METHODS: The ULTRA-BIFURCAT registry was obtained by patient-level merging the BIFURCAT and ULTRA registries. Pairs of patients were generated with propensity score matching (PSM). The primary outcome of interest was major adverse cardiac events (MACE) - a composite of all-cause death, myocardial infarction (MI), target lesion revascularisation (TLR) or stent thrombosis. A lesion-oriented composite outcome (LOCO) - a composite of target vessel MI (TVMI) or TLR - along with each single component of MACE represented the secondary outcomes. Subgroup analyses included the site of bifurcation (unprotected left main [ULM] vs non-ULM), side branch involvement (true bifurcation vs non-true bifurcation), side branch diameter and lesion length. Follow-up was censored at 800 days. RESULTS: A total of 5,607 patients undergoing a provisional stenting technique were selected for the present analysis. PSM generated 1,784 pairs. Between the matched patients with FKB versus no FKB, no significant difference in MACE was observed (9.0% vs 8.6%; p=0.68). FKB was associated with a lower rate of the LOCO (1.9% vs 2.9%; p=0.04) compared to the no FKB group, driven by lower rates of TVMI (0.2% vs 0.5%; p=0.03) and TLR (1.8% vs 2.6%; p=0.14). These results were confirmed in the subgroups of patients treated for bifurcations with side branches with a diameter >2.5 mm and for true coronary bifurcation lesions. CONCLUSIONS: Among patients treated for coronary bifurcation lesions with provisional stenting, FKB had no significant impact on MACE but was associated with a mild reduction in the incidence of the LOCO.

Accesso banca dati bibliografica

PMID : 40091870

DOI : 10.4244/EIJ-D-24-00471

Keywords

Drug-Eluting Stents; Registries; Treatment Outcome; Coronary Artery Disease/therapy/diagnostic imaging; Angioplasty, Balloon, Coronary/instrumentation/methods/adverse effects; Middle Aged; Aged; Male; Female; Humans; Myocardial Infarction/etiology; Percutaneous Coronary Intervention/methods/adverse effects/instrumentation; Stents;