Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan.
Catheter Cardiovasc Interv. 2020 Jul;96(1):20-28. doi: 10.1002/ccd.28812. Epub 2020 Feb 25.
To evaluate the short-, long-term clinical and angiographic outcomes after treatment of true bifurcation lesions using a modified jailed balloon technique (MJBT).
Percutaneous coronary intervention (PCI) for true bifurcation lesions has high risk for adverse events. Side branch (SB) occlusion is one of the most serious complications. Therefore, novel strategies to avoid SB occlusion during main branch stenting and to keep its patency are important.
Between February 2015 and February 2018, 328 patients with 349 true bifurcation lesions underwent PCI using MJBT. True bifurcation lesions were defined as Medina classifications (1.1.1), (1.0.1) or (0.1.1) lesions. We investigated the procedural and long-term clinical outcomes. Furthermore, angiographic outcomes were assessed at follow-up diagnostic angiography. The mean age of patients was 71.6 ± 9.9 years. Procedural success was achieved in all patients; postoperative SB occlusion was noted in only one patient (0.3%). The cumulative incidence of all-cause death was 23 patients (7.0%) in the follow-up period (median 717 days). Target lesion revascularization was performed in 19 patients (5.8%) with 23 lesions (6.6%), and 0.6% of myocardial infarction and 0% of definite stent thrombosis were observed. Angiographic follow-up was performed in 243 patients (74.1%); the percent diameter stenosis in SB was not significantly different between after the index procedure and follow-up angiography.
This MJBT is safe and effective in preserving SB patency for true bifurcation lesions. Furthermore, long-term clinical and angiographic outcomes after MJBT are feasible.
评价改良 jailed 球囊技术（MJBT）治疗真性分叉病变的短期和长期临床及血管造影结果。
真性分叉病变经皮冠状动脉介入治疗（PCI）发生不良事件的风险较高。边支（SB）闭塞是最严重的并发症之一。因此，避免主支支架置入时 SB 闭塞并保持其通畅的新策略很重要。
2015 年 2 月至 2018 年 2 月，328 例 349 处真性分叉病变患者接受 MJBT 治疗。真性分叉病变定义为 Medina 分类（1.1.1）、（1.0.1）或（0.1.1）病变。我们研究了手术过程和长期临床结果。此外，在随访诊断性血管造影时评估了血管造影结果。患者平均年龄为 71.6±9.9 岁。所有患者均获得手术成功；术后仅 1 例（0.3%）患者出现 SB 闭塞。在随访期间（中位时间 717 天），共有 23 例（7.0%）患者发生全因死亡。在 19 例（5.8%）患者中，共 23 处病变进行了靶病变血运重建，观察到心肌梗死发生率为 0.6%，确定支架血栓形成发生率为 0%。对 243 例（74.1%）患者进行了血管造影随访；SB 的血管造影狭窄百分比在指数操作后和随访血管造影之间无显著差异。
该 MJBT 安全有效，可保持真性分叉病变 SB 的通畅性。此外，MJBT 后的长期临床和血管造影结果是可行的。
