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Goldberg A, Shlofmitz E, Sosa F, Thomas S, Nguyen J, Tsioulias A, Fazal A, Shin D, Sakai K, Moses JW, Ali ZA, Shlofmitz RA, Jeremias A. BOOM: A novel bifurcation stent technique using optical coherence tomography co-registration. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2024:S1553-8389(24)00589-X. [PMID: 39097428 DOI: 10.1016/j.carrev.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/05/2024] [Accepted: 07/17/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND/PURPOSE Bifurcation lesions comprise 20 % of percutaneous coronary interventions (PCI) and are associated with worse long-term outcomes. With an increasing percentage of patients presenting with complex anatomy, including bifurcation disease, there is a need for treatment strategies to optimize PCI outcomes. METHODS/MATERIALS We retrospectively analyzed 48 patients undergoing OCT guided bifurcation PCI using the 'Bifurcation and Ostial OCT Mapping' (BOOM) technique. The primary efficacy variable studied was stent precision following deployment, defined as the distance of the most proximal stent strut from the true ostium of the target vessel. Additionally, targeted follow-up occurred by phone at 6- and 12-months post procedure, where the frequency of myocardial infarction, target lesion revascularization, target vessel and non-target vessel revascularization, and mortality were collected. RESULTS A total of 40 (83.3 %) had an ostial lesion that required treatment while the remaining patients had true bifurcation disease. Most target lesions were in either the LAD or its branches (29 lesions (60.3 %)). With respect to stent positioning, the median absolute geographic miss, (i.e., stent protrusion into the main branch or lack of complete ostial stent coverage), was 0.75 mm. At 6 months, one patient required target lesion revascularization with no additional patients at 12 months. CONCLUSIONS BOOM is a safe and simple strategy that can be a useful technique to optimize precise stent placement for ostial and bifurcation lesions.
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Affiliation(s)
- Alec Goldberg
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America; Tulane University School of Medicine, New Orleans, LA, United States of America
| | - Evan Shlofmitz
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - Fernando Sosa
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - Susan Thomas
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - James Nguyen
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - Anna Tsioulias
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - Alysse Fazal
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - Doosup Shin
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - Koshiro Sakai
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - Jeffery W Moses
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America; Cardiovascular Research Foundation, New York, NY, United States of America
| | - Ziad A Ali
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America; Cardiovascular Research Foundation, New York, NY, United States of America
| | - Richard A Shlofmitz
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America
| | - Allen Jeremias
- St. Francis Hospital & Heart Center, Roslyn, New York, United States of America; Cardiovascular Research Foundation, New York, NY, United States of America
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Kassier A, Kassab K, Fischell TA. Kissing Balloon-Stent Technique for Simple Bifurcation Lesions. J Clin Med 2024; 13:2645. [PMID: 38731174 PMCID: PMC11084643 DOI: 10.3390/jcm13092645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/19/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Coronary bifurcation lesions are commonly encountered during coronary angiography. The management of bifurcation lesions remains challenging, with various bifurcation techniques being available and outcomes varying depending on the Medina classification and operator experience. Methods: We present a short case series and the outcomes of a new bifurcation technique for the management of simple Medina '0,0,1' and '0,0,1' bifurcation lesions using the kissing balloon-stent technique (kissing BS). Results: We retrospectively identified 8 patients who underwent bifurcation stenting using the kissing Balloon-Stent technique, along with their clinical and angiographic follow-up outcomes. We also describe the benefits and limitations of the technique, delineate the potential mechanisms of target lesion failure, and outline appropriate patient selection. Conclusions: Kissing Balloon-Stent technique is a simple single stent technique that is safe and feasible in select patients with Medina '0,0,1' and '0,0,1' bifurcation lesions.
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Affiliation(s)
- Adnan Kassier
- Division of Cardiology, Mercy Heart Hospital, Springfield, MO 65804, USA;
- Division of Cardiology, University of Missouri, Columbia, MO 65212, USA
| | - Kameel Kassab
- Division of Cardiology, Yuma Regional Medical Center, Yuma, AZ 85364, USA
| | - Tim A. Fischell
- Division of Cardiology, Ascension Borgess Hospital, Kalamazoo, MI 49048, USA;
- Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, MI 49008, USA
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