A Novel-Modified Provisional Bifurcation Stenting Technique: Jailed Semi-Inflated Balloon Technique

• Published in: Journal of interventional cardiology Vol. 28; no. 5; pp. 420 - 429
• Main Authors: Çaylı, Murat, Şeker, Taner, Gür, Mustafa, Elbasan, Zafer, Şahin, Durmus Yildiray, Elbey, Mehmet Ali, Çil, Habib
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2015
• Subjects: Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - therapy; Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Angioplasty, Balloon, Coronary - methods; Coronary Angiography - methods; Coronary Vessels - pathology; Coronary Vessels - physiopathology; Female; Hemodynamics; Humans; Male; Middle Aged; Stents; Treatment Outcome
• ISSN: 0896-4327; 1540-8183
• DOI: 10.1111/joic.12225

Objective We proposed a new technique for the treatment of coronary bifurcation lesions, called jailed semi‐inflated balloon technique (JSBT). Background Currently, provisional approach is recommended to treat most of coronary bifurcation lesions. However, it is associated with the risk of side branch (SB) occlusion after main vessel (MV) stenting due to plaque or carina shift into the SB. The SB occlusion may cause peri‐procedural myonecrosis or hemodynamic compromise. Therefore, strategies are needed to reduce the SB occlusion during provisional approach. Methods Between September 2014 and April 2015, we selected 137 patients (104 male, 33 female; mean age 63.6 ± 11.7 years) with 148 distinct coronary bifurcation lesions underwent percutaneous coronary intervention using JSBT. All patients were followed with hospital visits or telephone contact up to 1 month. Results The majority of the patients had acute coronary syndrome (64.2%) and Medina 1.1.1. bifurcation lesions (62.8%). The lesion localization was distal left main (LM) coronary artery in 28 patients. After the MV stenting, thrombolysis in myocardial infarction (TIMI) 3 flow was established in 100% of both MV and SB. There was no SB occlusion in any patient. There was no major adverse cardiac event during in‐hospital stay and 1 month follow‐up. Conclusions The JSBT technique can be successfully performed in both LM and non‐LM bifurcation lesion. This technique provides high rate of procedural success, excellent SB protection during MV stenting and excellent immediate clinical outcome. (J Interven Cardiol 2015;28:420–429)