Final kissing ballooning and long-term clinical outcomes in coronary bifurcation lesions treated with 1-stent technique: Results from the COBIS registry

Hyeon Cheol Gwon, Joo Yong Hahn, Bon Kwon Koo, Young Bin Song, Seung Hyuk Choi, Jin Ho Choi, Sang Hoon Lee, Myung Ho Jeong, Hyo Soo Kim, In Whan Seong, Ju Young Yang, Seung Woon Rha, Yangsoo Jang, Jung Han Yoon, Seung Jea Tahk, Ki Bae Seung, Seung Jung Park

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Abstract

Background: Whether final kissing ballooning (FKB) is mandatory in the 1-stent technique is uncertain. Objective: To evaluate the effect of FKB on long-term clinical outcomes in coronary bifurcation lesions treated with the 1-stent technique. Methods: Consecutive patients undergoing percutaneous coronary intervention using drug-eluting stents for non-left main bifurcation lesions were enrolled from 16 centres in Korea between January 2004 and June 2006. In patients treated with the 1-stent technique major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), or target lesion revascularisation (TLR)) were compared between those undergoing main vessel stenting only (non-FKB group, n=736) or those undergoing FKB after main vessel stenting (FKB group, n=329). Propensity score-matching analysis was also performed in 222 patient pairs (444 from the non-FKB group and 222 from the FKB group). Results: During follow-up (median 22 months), the FKB group had a higher incidence of MACE (HR 2.58; 95% CI 1.52 to 4.37; p<0.001) and TLR (HR 3.63; 95% CI 2.00 to 6.56; p<0.001), but not of cardiac death or MI. Most TLR occurred in the main vessel (HR 3.39 for the FKB group; 95% CI 1.86 to 6.19; p<0.001). The rate of stent thrombosis was similar in both groups (0.5% in the non- FKB group vs 0.6% in the FKB group, p=0.99). After propensity score matching, the FKB group still had higher rates of MACE and TLR than the non-FKB group (HR 2.13; 95% CI 1.15 to 3.95; p=0.02 and HR 2.84; 95% CI 1.45 to 5.55; p=0.002, respectively). Conclusions: In patients treated with the 1-stent technique for bifurcation lesions, FKB after main vessel stenting may be harmful mainly due to increased TLR. Trial Registration Number: clinicaltrials.gov number: NCT00851526.

Original languageEnglish
Pages (from-to)225-231
Number of pages7
JournalHeart
Volume98
Issue number3
DOIs
Publication statusPublished - 2012 Feb

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Gwon, H. C., Hahn, J. Y., Koo, B. K., Song, Y. B., Choi, S. H., Choi, J. H., Lee, S. H., Jeong, M. H., Kim, H. S., Seong, I. W., Yang, J. Y., Rha, S. W., Jang, Y., Yoon, J. H., Tahk, S. J., Seung, K. B., & Park, S. J. (2012). Final kissing ballooning and long-term clinical outcomes in coronary bifurcation lesions treated with 1-stent technique: Results from the COBIS registry. Heart, 98(3), 225-231. https://doi.org/10.1136/heartjnl-2011-300322