Assessment of side branch patency using a jailed semi-inflated balloon technique with coronary bifurcation lesions

Abstract

Objective: Many interventional cardiologists are concerned about the risk of side branch (SB) loss during main vessel (MV) stenting in complex bifurcation lesions. Therefore, novel techniques are required to reduce the risk of SB occlusion. The jailed semi-inflated balloon technique (JSBT) is one of these techniques. This article is a description of clinical experience with SB patency assessment using the JSBT. Methods: A total of 64 patients with 82 distinct coronary bifurcation lesions underwent percutaneous coronary intervention (PCI) via JSBT at this institution. In the majority of patients, the SB balloon was inflated with a greater pressure (4.8+-2.0 atm) than in the standard JSBT. Procedural and immediate clinical outcomes were reviewed via baseline and post-procedural quantitative coronary angiography analysis. Results: The majority of the patients had acute coronary syndrome (60.9%) and almost one-third of the patients were Medina class 1.1.1. (32.8%). A jailed-balloon or wire was not entrapped during any PCI. SB ostial dissection was seen in only 2 patients. The minimal lumen diameter was improved in the MV and SB following PCI. There were no adverse cardiac events during in-hospital stay or at 1-month follow-up. Conclusion: JSBT provides maximum SB protection with bifurcation lesions and requires less time than a complex technique. There was no significant SB occlusion risk even though the SB balloon was inflated with a slightly higher pressure. The immediate clinical outcomes and procedural success of this study may encourage interventional cardiologists to use this technique safely with reliable preservation of SB patency.

Keywords

• coronary bifurcation lesion
• jailed semi-inflated balloon technique; percutaneous coronary intervention.