Does Every Bifurcation Lesion Need a Kiss?

In patients with adequate side-branch flow after main-vessel stenting, final kissing balloon dilatation did not confer a clinical benefit.

Little consensus exists on which of many methods of percutaneous coronary intervention is optimal for treating bifurcation lesions. The Nordic Bifurcation Study (JW Cardiol Nov 29 2006) led to a preference for a provisional side-branch (SB) stenting strategy. However, when SB stenting is provisional, it's not clear which technique is best or whether final kissing balloon dilatation (FKBD) is needed.

In this manufacturer-supported, nonblinded, multicenter trial, 477 patients with bifurcation lesions and Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow in the SB after main-vessel stenting were randomized to FKBD or no FKBD. Only patients who had TIMI flow grade <3 in the SB after FKBD (about 1%) received an SB stent.

Six-month clinical…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI