Buddy-balloon technique for final kissing-balloon dilatation after crush stenting of the left main coronary artery.

BACKGROUND

Crush stenting mandates a final kissing-balloon technique (KBT) for a better clinical outcome; however, recrossing the 2 overlapping stent struts with the balloon catheter is technically challenging.

OBJECTIVES

The efficacy of the buddy-balloon technique for facilitating completion of the final KBT during crush stenting of the left main coronary artery (LMCA) was evaluated.

METHODS

The records of 38 consecutive patients who underwent crush stenting for a lesion in the distal LMCA from January 2005 to December 2009 were retrospectively reviewed.

RESULTS

In 23 of the 38 patients, recrossing the balloon catheter to the left circumflex artery (LCX) was difficult, even with appropriate backup support from the guiding catheter. To enhance recrossing of the balloon catheter, the buddy-balloon technique was used, which resulted in the successful completion of the final KBT in 21 patients (91.3%). For the 2 patients in whom the technique was unsuccessful, the final KBT was subsequently achieved by performing the buddy-balloon technique in the LCX using a 1.5 mm balloon catheter. The overall success rate of the final KBT was 100%. One year after the procedure, target lesion revascularization (TLR) rate of these 23 cases showed no significant difference when compared with the TLR rate of patients for whom this technique was not needed.

CONCLUSION

The buddy-balloon technique is a suitable option when used in the context of crush stenting in patients with lesions of the distal LMCA.