Impact of final kissing balloon inflation on vessel healing following drug-eluting stent implantation: Insight from the optical coherence tomography sub-study of the J-REVERSE trial

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• 作者：Hachidai Takahashi ; MD^a ; Hiromasa Otake ; MD^a ; Toshiro Shinke ; MD ; FJCC^a ; ^{shinke@med.kobe-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yoshinobu Murasato ; MD^b ; Yoshihisa Kinoshita ; MD^c ; Masahiro Yamawaki ; MD^d ; Yoshihiro Takeda ; MD^e ; Kenichi Fujii ; MD^f ; Shin-ichiro Yamada ; MD^g ; Yoshihisa Shimada ; MD ; FJCC^h ; Takehiro Yamashita ; MDⁱ ; Kazuhiko Yumoto ; MD^j ; Ken-ichi Hirata ; MD ; FJCC^a
• 关键词：Coronary bifurcation ; Optical coherence tomography ; Drug-eluting stent
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：68
• 期：6
• 页码：504-511
• 全文大小：1374 K

文摘

We sought to clarify the impact of final kissing inflation (FKI) after single stenting of bifurcation lesions on vessel healing.

Methods

From the J-REVERSE registry enrolling 303 bifurcation lesions treated with provisional single stenting using sirolimus- (SES) or everolimus-eluting stent (EES), 65 lesions treated with (n = 30) and without (n = 35) FKI underwent 9-month follow-up optical coherence tomography. Average stent eccentricity index (SEI: minimum/maximum stent diameter) and neointimal unevenness score (NUS: maximum/average neointimal thickness of the same cross-section) for the proximal, bifurcation, and distal segments were compared between FKI and non-FKI groups.

Results

At the proximal segment, the FKI group demonstrated significantly larger average stent area with greater asymmetric stent expansion, and average lumen area remained significantly larger at 9-month follow-up despite a tendency toward greater neointimal proliferation. Jailed strut and thrombus incidence were also significantly lower at the side branch orifice, and NUS was significantly smaller at the bifurcation and proximal segments in the FKI group.

Conclusions

Nine months after SES and EES treatment of bifurcation lesions, FKI reduced proximal-segment luminal narrowing. Considering its homogeneous neointimal distribution and fewer jailed struts, FKI may be beneficial for treating bifurcation lesions.