Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Nantan, Japan.
J Interv Cardiol. 2021 Feb 18;2021:8839897. doi: 10.1155/2021/8839897. eCollection 2021.
This study aimed to investigate the optimal jailed balloon inflation in the side branch during the modified jailed balloon technique for bifurcated lesions.
The modified jailed balloon technique is one of the effective techniques to minimize the emergence of side branch (SB) compromise by preventing plaque or carina shifting during a single stent strategy in the main vessel with provisional SB treatment. However, there are no detailed studies on the method of optimal jailed balloon inflation.
We analyzed 51 consecutive patients who underwent percutaneous coronary intervention (PCI) for bifurcated lesions with a modified jailed balloon technique between September 2018 and December 2020. These 51 patients were divided into two groups according to the magnitude of inflation pressure of the jailed balloon: a higher pressure (HP) group and lower pressure (LP) group.
No significant differences in procedural outcomes were observed between the two groups. The findings of SB compromise were relatively common with our procedure (30.0% in the HP group; 33.3% in the LP group). The patterns of SB compromise such as dissection or stenosis increase were observed at similar frequencies between them. In particular, SB dissection was noted in the SB lesion with some plaque burden, irrespective of the magnitude of the jailed balloon inflation pressure. Univariate analysis showed that calcification in the main vessel and SB lesion length was significantly associated with SB compromise. Finally, all PCI procedures were successfully completed without any provisional stent deployment in SB.
We speculate that lesion characteristics rather than the PCI procedural factors may be critical determinants to cause SB compromise.
本研究旨在探讨改良双球囊技术中边支（SB）嵌顿球囊充气的最佳压力。
改良双球囊技术是一种有效的技术，通过在主血管中单支架策略中临时处理边支（SB），防止斑块或嵴移位，从而最大限度地减少 SB 损伤的发生。然而，对于最佳嵌顿球囊充气方法还没有详细的研究。
我们分析了 2018 年 9 月至 2020 年 12 月期间采用改良双球囊技术行 PCI 治疗的 51 例分叉病变患者。根据嵌顿球囊充气压力的大小，将这 51 例患者分为两组：高压力（HP）组和低压力（LP）组。
两组患者在手术结果方面无显著差异。SB 损伤的发生率相对较高（HP 组为 30.0%；LP 组为 33.3%）。两组之间 SB 损伤的模式（如夹层或狭窄加重）的发生率相似。特别是在 SB 病变有一定斑块负荷的情况下，SB 夹层的发生率与嵌顿球囊充气压力的大小无关。单因素分析显示，主血管和 SB 病变长度的钙化与 SB 损伤显著相关。最后，所有 PCI 操作均成功完成，SB 未进行临时支架植入。
我们推测病变特征而不是 PCI 手术因素可能是导致 SB 损伤的关键决定因素。
