Toshiki Kuno
,
Mount Sinai Beth Israel, New York, NY
Takehiro Sugiyama
,
Diabetes and Metabolism Information Center, Research Institute, Center for Global Health and Medicine, Tokyo, Japan
Shohei Imaeda
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Kenji Hashimoto
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Toshinobu Ryuzaki
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Souichi Yokokura
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Tetsuya Saito
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Hiroyuki Yamazaki
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Ryota Tabei
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Masaki Kodaira
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Yohei Numasawa
,
Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan, Ashikaga, Japan
Background:
The optimal technique for percutaneous coronary intervention (PCI) of a bifurcation lesion remains uncertain. JBT/JCT techniques are now emerging for protection of the side branch (SB). We aimed to compare jailed balloon (JBT) and jailed Corsair (JCT) techniques to the conventional jailed wire technique.
Methods:
We analyzed 850 consecutive patients (995 bifurcation lesions), who underwent PCI. The bifurcation lesions were classified as jailed wire (-), jailed wire (+), JBT, and JCT. We assessed temporary thrombolysis in myocardial infarction (TIMI) flow grade ≤2, permanent TIMI flow grade ≤2 in the SB, and SB occlusion related myocardial infarction and compared these endpoints with inverse probability treatment weighted analysis.
Results:
The percentage of each group is as follows: jailed wire (-); 44.7%; jailed wire (+) 50.9%; JBT 1.7%; JCT 2.7%. The Corsair could not be delivered with a stent because of severe calcifications (3.7%) and a jailed balloon was entrapped with the stent after dilatation (5.9%). Compared to the jailed wire (+), JBT/JCT had a higher percentage of true bifurcations, arterial sheath size ≥7 Fr, and a lower proportion of wire recrossing (all, P<0.05). After adjustment, temporary and permanent TIMI flow grade ≤2 in the SB, and SB occlusion related myocardial infarction were not significantly different (OR: 1.08, CI: 0.32-3.71, P=0.90; OR: 0.88, CI: 0.11-6.91, P=0.91; OR: 1.94, CI: 0.23-16.5, P=0.55 respectively).
Conclusions:
Our data could not prove the efficacy of JBT/JCT, but revealed novel insights about these techniques. A larger study is necessary to prove the efficacy of JBT/JCT.
