Long-term clinical outcomes after kissing balloon inflation in patients with coronary bifurcation lesions treated with provisional stenting technique. Results from the real-world multicenter registry

Dmitrii Khelimskii; Ivan Bessonov; Maksim Kashtanov; Stanislav Sapozhnikov; Aram Badoian; Aleksey Baranov; Serezha Manukyan; Ruslan Utegenov; Oleg Krestyaninov

doi:10.1016/j.ihj.2023.05.003

Long-term clinical outcomes after kissing balloon inflation in patients with coronary bifurcation lesions treated with provisional stenting technique. Results from the real-world multicenter registry

Indian Heart J. 2023 Sep-Oct;75(5):313-320. doi: 10.1016/j.ihj.2023.05.003. Epub 2023 May 11.

Authors

Dmitrii Khelimskii¹, Ivan Bessonov², Maksim Kashtanov³, Stanislav Sapozhnikov², Aram Badoian⁴, Aleksey Baranov⁴, Serezha Manukyan⁴, Ruslan Utegenov², Oleg Krestyaninov⁴

Affiliations

¹ Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation. Electronic address: dkhelim@mail.ru.
² Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 625026, Russian Federation.
³ Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 625026, Russian Federation; Ural Federal University, Ekaterinburg, Russian Federation.
⁴ Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation.

Abstract

Objective: There is a lack of data regarding the long-term clinical efficacy of the kissing balloon inflation (KBI) after provisional stenting of coronary bifurcation lesions. The aim of this study was to analyze the impact of KBI on long-term clinical outcomes in patients undergoing provisional stenting for the coronary bifurcation lesions in a large real-world population.

Methods: A total of 873 patients who underwent percutaneous coronary interventions (PCI) with provisional stenting and had clinical follow up were analyzed. Patients treated with 2-stent strategy were excluded. To reduce the effect of potential confounding factors in this observational study, propensity score matching was conducted.

Results: KBI was performed in 325 patients (37.2%). The median follow-up duration was 37.3 months. Patients treated with KBI more often had a previous PCI (48.6% vs. 42.5% SMD = 0.123). Patients in non-kissing group had more complex coronary disease with higher prevalence of calcification (14.8% vs. 21.4% SMD = 0.172), thrombosis (2.8% vs. 5.8% SMD = 0.152) and longer side branch lesions (8.3% vs. 11.7% SMD = 0.113). There were no significant differences in the major adverse cardiac events including death, myocardial infarction, target lesion revascularization after KBI versus no KBI (15.4% vs. 15.7%, p = 0.28), in total cohort or in matched patients (17.1% vs. 15.8%, adjusted HR 1.01, 95% CI: 0.65-1.65, p = 0.95). The lack of effect of KBI on clinical outcomes was consistent across various subgroups including left main disease.

Conclusion: In this multicenter real-world registry, KBI did not improve long-term clinical outcomes in patients with coronary bifurcation lesions treated with provisional stenting technique.

Keywords: Coronary bifurcation; Kissing-dilatation; Left main; Percutaneous coronary interventions; Provisional stenting.

Publication types

Editorial