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Vascular healing after kissing balloon inflation: Nine-month 3D optical coherence tomography analysis in corelab

BACKGROUND: The jailing strut configuration with link-free and distal guidewire recrossing (LFD) at the side branch orifice (SBO) reduces incomplete stent apposition (ISA) after kissing balloon technique (KBT) in crossover stenting of coronary bifurcation lesions (CBLs). However, data regarding vasc...

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Autores principales: Yamawaki, Masahiro, Okamura, Takayuki, Nagoshi, Ryoji, Fujimura, Tatsuhiro, Murasato, Yoshinobu, Ono, Shiro, Serikawa, Takeshi, Hikichi, Yutaka, Norita, Hiroaki, Nakao, Fumiaki, Sakamoto, Tomohiro, Shinke, Toshiro, Shite, Junya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052145/
https://www.ncbi.nlm.nih.gov/pubmed/35495581
http://dx.doi.org/10.1016/j.ijcha.2022.101034
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author Yamawaki, Masahiro
Okamura, Takayuki
Nagoshi, Ryoji
Fujimura, Tatsuhiro
Murasato, Yoshinobu
Ono, Shiro
Serikawa, Takeshi
Hikichi, Yutaka
Norita, Hiroaki
Nakao, Fumiaki
Sakamoto, Tomohiro
Shinke, Toshiro
Shite, Junya
author_facet Yamawaki, Masahiro
Okamura, Takayuki
Nagoshi, Ryoji
Fujimura, Tatsuhiro
Murasato, Yoshinobu
Ono, Shiro
Serikawa, Takeshi
Hikichi, Yutaka
Norita, Hiroaki
Nakao, Fumiaki
Sakamoto, Tomohiro
Shinke, Toshiro
Shite, Junya
author_sort Yamawaki, Masahiro
collection PubMed
description BACKGROUND: The jailing strut configuration with link-free and distal guidewire recrossing (LFD) at the side branch orifice (SBO) reduces incomplete stent apposition (ISA) after kissing balloon technique (KBT) in crossover stenting of coronary bifurcation lesions (CBLs). However, data regarding vascular healing after KBT are lacking. We investigated vascular healing 9 months after crossover stenting followed by KBT with optical coherence tomography (OCT) guidance in a prospective multicenter registry. METHODS: Fifty-nine patients with CBLs (LFD, 35 patients; non-LFD, 24 patients) were studied. The jailing configuration of the SB and the wire-recrossing position, incidence of ISA and uncovered struts, and neointima unevenness score (NUS) in the main vessel (MV) after 9 months were determined by off-line 3D-OCT in the core laboratory. RESULTS: The ISA rate was significantly higher at the SB ostium and distal MV after KBT in the non-LFD group, compared to the LFD group. After 9 months, incidence of ISA (18.3 ± 18.2 vs. 6.0 ± 8.7%, p < 0.01) and uncovered struts (8.7 ± 9.9 vs. 4.7 ± 7.3 %, p = 0.08) were higher at the SB ostium with higher SB restenosis in the non-LFD group. In distal MV, NUS was significantly higher (3.1 ± 1.1 vs. 2.5 ± 0.6, p < 0.05). In true-CBLs, an increase in uncovered struts and ISA rate was prominent in the proximal MV and opposite SB. No differences were observed in the 9-month clinical outcomes. CONCLUSION: Visualization of the wire recrossing point and the SB-jailing strut pattern by OCT plays an important role to optimize the KBT in CBL stenting, resulting in favorable mid-term vascular healing.
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spelling pubmed-90521452022-04-30 Vascular healing after kissing balloon inflation: Nine-month 3D optical coherence tomography analysis in corelab Yamawaki, Masahiro Okamura, Takayuki Nagoshi, Ryoji Fujimura, Tatsuhiro Murasato, Yoshinobu Ono, Shiro Serikawa, Takeshi Hikichi, Yutaka Norita, Hiroaki Nakao, Fumiaki Sakamoto, Tomohiro Shinke, Toshiro Shite, Junya Int J Cardiol Heart Vasc Original Paper BACKGROUND: The jailing strut configuration with link-free and distal guidewire recrossing (LFD) at the side branch orifice (SBO) reduces incomplete stent apposition (ISA) after kissing balloon technique (KBT) in crossover stenting of coronary bifurcation lesions (CBLs). However, data regarding vascular healing after KBT are lacking. We investigated vascular healing 9 months after crossover stenting followed by KBT with optical coherence tomography (OCT) guidance in a prospective multicenter registry. METHODS: Fifty-nine patients with CBLs (LFD, 35 patients; non-LFD, 24 patients) were studied. The jailing configuration of the SB and the wire-recrossing position, incidence of ISA and uncovered struts, and neointima unevenness score (NUS) in the main vessel (MV) after 9 months were determined by off-line 3D-OCT in the core laboratory. RESULTS: The ISA rate was significantly higher at the SB ostium and distal MV after KBT in the non-LFD group, compared to the LFD group. After 9 months, incidence of ISA (18.3 ± 18.2 vs. 6.0 ± 8.7%, p < 0.01) and uncovered struts (8.7 ± 9.9 vs. 4.7 ± 7.3 %, p = 0.08) were higher at the SB ostium with higher SB restenosis in the non-LFD group. In distal MV, NUS was significantly higher (3.1 ± 1.1 vs. 2.5 ± 0.6, p < 0.05). In true-CBLs, an increase in uncovered struts and ISA rate was prominent in the proximal MV and opposite SB. No differences were observed in the 9-month clinical outcomes. CONCLUSION: Visualization of the wire recrossing point and the SB-jailing strut pattern by OCT plays an important role to optimize the KBT in CBL stenting, resulting in favorable mid-term vascular healing. Elsevier 2022-04-23 /pmc/articles/PMC9052145/ /pubmed/35495581 http://dx.doi.org/10.1016/j.ijcha.2022.101034 Text en © 2022 The Authors. Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Yamawaki, Masahiro
Okamura, Takayuki
Nagoshi, Ryoji
Fujimura, Tatsuhiro
Murasato, Yoshinobu
Ono, Shiro
Serikawa, Takeshi
Hikichi, Yutaka
Norita, Hiroaki
Nakao, Fumiaki
Sakamoto, Tomohiro
Shinke, Toshiro
Shite, Junya
Vascular healing after kissing balloon inflation: Nine-month 3D optical coherence tomography analysis in corelab
title Vascular healing after kissing balloon inflation: Nine-month 3D optical coherence tomography analysis in corelab
title_full Vascular healing after kissing balloon inflation: Nine-month 3D optical coherence tomography analysis in corelab
title_fullStr Vascular healing after kissing balloon inflation: Nine-month 3D optical coherence tomography analysis in corelab
title_full_unstemmed Vascular healing after kissing balloon inflation: Nine-month 3D optical coherence tomography analysis in corelab
title_short Vascular healing after kissing balloon inflation: Nine-month 3D optical coherence tomography analysis in corelab
title_sort vascular healing after kissing balloon inflation: nine-month 3d optical coherence tomography analysis in corelab
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052145/
https://www.ncbi.nlm.nih.gov/pubmed/35495581
http://dx.doi.org/10.1016/j.ijcha.2022.101034
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